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One week after discharge of a postpartum client, the client's husband calls the postpartum unit and asks the nurse, 'Is it normal for my wife to cry at the drop of a hat? I'm worried I've done something to upset her.' The nurse's best initial response would be:
- A. Have you noticed any pattern to her periods of crying?
- B. Try not to worry about it. I'm sure it's just the postpartum blues.
- C. Can you think of something you might have done to upset her?
- D. Let's consider some of the ways you can decrease her depression.
Correct Answer: B
Rationale: Postpartum blues are common within the first two weeks, characterized by emotional lability. Reassuring the husband while acknowledging the normalcy of this condition is appropriate.
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A client is admitted with suspected acute pancreatitis. Which lab finding confirms the diagnosis?
- A. Blood glucose of 260 mg/dL
- B. White cell count of 21,000 cu/mm
- C. Platelet count of 250,000 cu/mm
- D. Serum amylase level of 600 units/dL
Correct Answer: D
Rationale: Elevated serum amylase levels, particularly above 3 times the normal range, confirm acute pancreatitis due to pancreatic enzyme release.
The nurse is administering an intermittent tube feeding to a client through a nasogastric tube. Which of the following positions is optimal for tube feedings?
- A. The head of the bed is elevated to 45°.
- B. The head of the bed is elevated to 90°.
- C. The head of the bed is elevated to 30°.
- D. The head of the bed is flat with the client supine.
Correct Answer: A
Rationale: Elevating the head of the bed to 45° (A) during tube feedings reduces the risk of aspiration and promotes digestion. A 90° elevation (B) is excessive, 30° (C) is insufficient, and a flat position (D) increases aspiration risk.
The client is having a cardiac catheterization. During the procedure, the client tells the nurse, 'I'm feeling really hot.' Which response would be best?
- A. You are having an allergic reaction. I will get an order for Benadryl.
- B. That feeling of warmth is normal when the dye is injected.
- C. That feeling of warmth indicates that the clots in the coronary vessels are dissolving.
- D. I will tell your doctor and let him explain to you the reason for the hot feeling that you are experiencing.
Correct Answer: B
Rationale: A warm sensation is a normal response to the injection of contrast dye during cardiac catheterization.
A client is provided instructions for a low-sodium diet. Which statement by the client indicates an understanding of the diet?
- A. I'll miss eating tomatoes.
- B. I'll enjoy eating take-out more frequently.
- C. I'll avoid potato chips and cheese.
- D. I'll miss eating celery.
Correct Answer: C
Rationale: Potato chips and cheese are high-sodium foods, and avoiding them shows understanding of a low-sodium diet. Tomatoes and celery are low-sodium, and take-out is often high-sodium.
The physician has ordered a serum aminophylline level for a client with chronic obstructive lung disease. The nurse knows that the therapeutic range for aminophylline is:
- A. 1-3 micrograms/mL
- B. 4-6 micrograms/mL
- C. 7-9 micrograms/mL
- D. 10-20 micrograms/mL
Correct Answer: D
Rationale: The therapeutic range for aminophylline is 10-20 micrograms/mL to effectively manage symptoms of chronic obstructive lung disease.