Nokea
A nurse is caring for a woman during the fourth stage of labor. Which of the following best describes an action the nurse would take during this stage?
- A. Providing constant reinforcement and education about the labor process and assisting the woman with pushing
- B. Explaining unusual interventions such as the use of a fetal heart monitor
- C. Assisting with labor discomfort by modeling breathing
- D. Teaching the new mother positioning of the infant to assist with breast-feeding
Correct Answer: D
Rationale: In the fourth stage of labor, the nurse supports breastfeeding and assists with positioning the infant.
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When assessing a client’s activity-exercise pattern, which subjective finding has implications for nursing practice?
- A. A person’s decreased muscle tone
- B. A person’s amount of leisure time
- C. A person’s decreased range of motion
- D. A person’s use of a cane
Correct Answer: B
Rationale: The amount of leisure time is a subjective finding related to the person’s lifestyle, impacting nursing care.
Which factor has the greatest implication for a community nurse when developing a health promotion program for church members?
- A. The majority of members live within a 3-mile radius.
- B. The majority of members are African American.
- C. The majority of members are high school graduates.
- D. The majority of members are employed.
Correct Answer: B
Rationale: Demographic data, such as the race of the population, provides significant insight into health risks and necessary interventions, especially for health disparities.
A 62-year-old person reports difficulty with peripheral vision. Which disorder is likely?
- A. Presbyopia
- B. Glaucoma
- C. Cataracts
- D. Diabetic retinopathy
Correct Answer: B
Rationale: Glaucoma affects peripheral vision due to damage to the optic nerve.
Which nurse is functioning as a care manager?
- A. Nurse working with a family to coordinate care after their child experiences a second hospitalization for an asthma exacerbation
- B. Nurse providing asthma education in the office setting to a child with moderate, persistent asthma
- C. Nurse administering the appropriate antiinflammatory medication to a child admitted to the hospital with an asthma exacerbation
- D. Nurse making a home visit for a respiratory assessment to a child following an admission for an asthma exacerbation
Correct Answer: A
Rationale: Care managers help determine what medical care is necessary, monitor care, and arrange for individuals to receive the most cost-effective care in the most appropriate settings. They must collaborate with providers and with the client/family. Care managers are especially helpful following a client after discharge and clients with complex needs. A nurse working with a family to coordinate service after a hospitalization is a good example of services provided by a care manager.
For which of the following is Type 2 diabetes mellitus screening recommended?
- A. Overweight woman
- B. Teenager
- C. Man with hypertension
- D. Woman with a family history of Type 2 diabetes mellitus
Correct Answer: C
Rationale: Screening for Type 2 diabetes is recommended for individuals with hypertension.