Nokea
The client asks the nurse how the health care provider could tell she was pregnant 'just by looking inside.' What is the best explanation by the nurse?
- A. Bluish coloration of the cervix and vaginal walls
- B. Pronounced softening of the cervix
- C. Clot of very thick mucous that obstructs the cervical canal
- D. Slight rotation of the uterus to the right
Correct Answer: A
Rationale: Chadwick's sign is a bluish-purple coloration of the cervix and vaginal walls, occurring at 4 weeks of pregnancy, that is caused by vasocongestion.
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The nurse admitting a 5 month-old who vomited 9 times in the past 6 hours should observe for signs of which overall imbalance?
- A. Metabolic acidosis
- B. Metabolic alkalosis
- C. Some increase in the serum hemoglobin
- D. A little decrease in the serum potassium
Correct Answer: B
Rationale: Vomiting causes loss of acid from the stomach. Prolonged vomiting can result in excess loss of acid and lead to metabolic alkalosis. Findings include irritability, increased activity, hyperactive reflexes, muscle twitching and elevated pulse.
The nurse is assigned to work with the parents of a retarded child.
- A. What should the nurse include in the care plan for the parents of a retarded child?
- B. Interpret the grieving process for the parents.
- C. Discuss the reality of institutional placement.
- D. Assist the parents in making decisions and long-term plans for the child.
- E. Perform a family assessment to assist in the planning of intervention.
Correct Answer: D
Rationale: A family assessment is essential to understand the parents’ grieving, coping, and support needs, guiding tailored interventions. Interpreting grief, discussing placement, or assisting with plans are premature without first assessing the family’s situation.
The nurse is assessing a client who may be bulimic. What objective finding indicates bulimia?
- A. Low self-esteem
- B. Loss of tooth enamel
- C. Feeling of loss of control
- D. Feeling of social inadequacy
Correct Answer: B
Rationale: Loss of tooth enamel from frequent vomiting is an objective sign of bulimia, distinguishing it from subjective emotional symptoms.
Which of the following responses, if made to the client by the nurse, would be BEST?
- A. When did you first notice these symptoms?'
- B. Have you shared this information with anyone?'
- C. Are you concerned about your financial difficulties?'
- D. Would you like to discuss your situation with me?'
Correct Answer: A
Rationale: Strategy: 'BEST' indicates there may be more than one correct response. Remember therapeutic communication. (1) correct-open-ended question, encourages client to discuss when problems occurred (2) yes/no question, nontherapeutic, doesn't encourage discussion of symptoms (3) yes/no question, nontherapeutic, too confrontational, does not encourage discussion (4) yes/no question, nontherapeutic
A nursing student asks the nurse manager to explain the forces that drive health care reform. The appropriate response by the nurse manager should include
- A. The escalation of fees with a decreased reimbursement percentage
- B. High costs of diagnostic and end-of-life treatment procedures
- C. Increased numbers of elderly and of the chronically ill of all ages
- D. A steep rise in provider fees and in insurance premiums
Correct Answer: A
Rationale: The escalation of fees with a decreased reimbursement percentage. The percentage of the gross national product representing health care costs rose dramatically with reimbursement based on fee for service. Reimbursement for Medicare and Medicaid recipients based on fee for service also escalates health care costs.