Nokea
As a client progresses through pregnancy, she develops constipation. What is the primary cause of this problem during pregnancy?
- A. Decreased appetite
- B. Inadequate fluid intake
- C. Prolonged gastric emptying
- D. Reduced intestinal motility
Correct Answer: D
Rationale: During pregnancy, hormonal changes and mechanical pressure reduce motility in the small intestine, enhancing water absorption and promoting constipation. Although decreased appetite, inadequate fluid intake, and prolonged gastric emptying may contribute to constipation, they aren't the primary cause.
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During the assessment of a laboring client, the nurse notes that the FHT are loudest in the upper-left quadrant. The infant is most likely in which position?
- A. Left mentum anterior
- B. Left occipital anterior
- C. Left sacral anterior
- D. Left occipital transverse
Correct Answer: B
Rationale: Fetal heart tones loudest in the upper-left quadrant suggest a left occipital anterior position, where the fetus's back is aligned with the mother's left side. Other positions` positions are less likely.
The output from a client's indwelling catheter is 500 mL for the past 10 hours. The nurse should:
- A. Do nothing because the output is within normal limits.
- B. Notify the doctor because the output is too low.
- C. Replace the indwelling catheter.
- D. Force fluids to increase the output in the next 8 hours.
Correct Answer: A
Rationale: Urine output of 500 mL in 10 hours (50 mL/hour) is within normal limits (30-50 mL/hour). No intervention is needed.
After a painful exacerbation of rheumatoid arthritis, a patient is to begin a walking and exercise program.
An appropriate outcome would be that the patient:
- A. Avoids exercising when there is some discomfort.
- B. Is pain free while engaging in the activity program.
- C. Walks and exercise even when the pain is severe.
- D. Exercise unless the discomfort becomes too great.
Correct Answer: D
Rationale: Exercising until discomfort becomes too great balances activity with joint protection, promoting safe participation.
Following a small-bowel resection, a client develops fever and anemia. The surface surrounding the surgical wound is warm to the touch and necrotizing fasciitis is suspected. Another manifestation that would most suggest necrotizing fasciitis is:
- A. erythema
- B. leukocytosis
- C. pressurelike pain
- D. swelling
Correct Answer: C
Rationale: Severe pressurelike pain out of proportion to visible signs distinguishes necrotizing fasciitis from cellulitis. Erythema, leukocytosis, and swelling are present in both cellulitis and necrotizing fasciitis.
The wife of a man who is comatose following a head injury asks the nurse if she should visit him since he is unresponsive. How should the nurse reply initially?
- A. Explain that since he is unresponsive there is no need for her to be here
- B. Tell her that the nurse will call if there is any change
- C. Suggest that her presence is important even though he seems unaware
- D. Recommend that she ask his coworkers to visit
Correct Answer: C
Rationale: Presence of loved ones may provide comfort and stimulate awareness in comatose patients, supporting family involvement. Other responses discourage visitation.