Nokea
As the client reaches 6cm dilation, the nurse notes late decelerations on the fetal monitor. What is the most likely explanation of this pattern?
- A. The baby is sleeping.
- B. The umbilical cord is compressed.
- C. There is head compression.
- D. There is uteroplacental insufficiency.
Correct Answer: D
Rationale: Late decelerations indicate uteroplacental insufficiency, reducing fetal oxygenation during contractions.
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After a cardiac catheterization procedure, the nurse should ask the client to remain in which position?
- A. on the left side, with both knees bent slightly
- B. semi-Fowler's position
- C. supine with a small pillow under the head
- D. high-Fowler's position
Correct Answer: C
Rationale: The supine position with a small pillow under the head promotes comfort and prevents bleeding from the catheter insertion site (usually femoral) after cardiac catheterization.
Which play activity is best suited to the gross motor skills of the toddler?
- A. Coloring book and crayons
- B. Ball
- C. Building cubes
- D. Swing set
Correct Answer: B
Rationale: Playing with a ball encourages gross motor skills like kicking and throwing, suitable for a toddler's developmental stage.
A client with rheumatoid arthritis tells the nurse that she is having increasing difficulty cooking, cleaning, and attending to activities of daily living. Which of the following referrals is the most appropriate?
- A. Occupational therapist.
- B. Physical therapist.
- C. Home health agency.
- D. Assisted-living facility.
Correct Answer: A
Rationale: An occupational therapist (A) helps clients with rheumatoid arthritis adapt to difficulties with daily activities through adaptive techniques and equipment. Physical therapy (B), home health (C), or assisted living (D) may be secondary.
The client is having electroconvulsive therapy for treatment of severe depression. Prior to the ECT the nurse should:
- A. Apply a tourniquet to the client's arm.
- B. Administer an anticonvulsant medication.
- C. Ask the client if he is allergic to shell fish.
- D. Apply a blood pressure cuff to the arm.
Correct Answer: D
Rationale: Applying a blood pressure cuff allows monitoring of vital signs during ECT, which is a standard safety measure.
A client receiving high doses of hydromorphone (Dilaudid®) develops acute respiratory depression with a drop in blood pressure. Which of the following treatments is most indicated?
- A. Naloxone
- B. Naproxen
- C. Flumazenil
- D. Nortriptyline
Correct Answer: A
Rationale: Naloxone (A) reverses opioid-induced respiratory depression. Naproxen (B), flumazenil (C), and nortriptyline (D) are not appropriate.