Nokea
The client is admitted with a diagnosis of preterm labor. Which fetal monitoring technique is most appropriate?
- A. Non-stress test
- B. Biophysical profile
- C. Both A and B
- D. Neither A nor B
Correct Answer: C
Rationale: Preterm labor requires fetal monitoring to assess well-being. Non-stress tests evaluate fetal heart rate and biophysical profiles assess multiple parameters (e.g. movement amniotic fluid). Both are appropriate.
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When assessing a client, the nurse notes the typical skin rash seen with systemic lupus erythematosus. Which of the following descriptions correctly describes this rash?
- A. Small round or oval reddish brown macules scattered over the entire body
- B. Scattered clusters of macules, papules, and vesicles over the body
- C. Bright red appearance of the palmar surface of the hands
- D. Reddened butterfly shaped rash over the cheeks and nose
Correct Answer: D
Rationale: The appearance of small, round or oval reddish brown macules scattered over the entire body is characteristic of rubeola. The appearance of scattered clusters of macules, papules, and vesicles throughout the body is characteristic of chickenpox. Palmar redness is seen in clients with cirrhosis of the liver. The characteristic butterfly rash over the cheek and nose and into the scalp is seen with systemic lupus erythematosus.
A 6-year-old girl is visiting the outpatient clinic because she has a fever and a rash. The doctor diagnoses chickenpox. Her mother asks the nurse how many baby aspirins her daughter can have for fever. The nurse should:
- A. Advise the mother not to give her aspirin
- B. Ask if the client is allergic to aspirin before giving further information
- C. Assess the function of the client's cranial nerve VIII
- D. Check the aspirin bottle label to determine milligrams per tablet
Correct Answer: A
Rationale: Aspirin taken during a viral infection has been implicated as a predisposing factor to Reye's syndrome in children and adolescents. Children and adolescents should not be given aspirin. Allergy to aspirin is not related to Reye's syndrome. Tinnitus, caused by damage to the acoustic nerve, occurs with aspirin toxicity, but this is not related to Reye's syndrome. A 6-year-old child should not be given any baby aspirin.
The nurse is teaching a client with a history of hyperlipidemia about dietary modifications. The nurse should tell the client to avoid:
- A. Saturated fats
- B. Lean proteins
- C. Complex carbohydrates
- D. Fresh fruits
Correct Answer: A
Rationale: Saturated fats increase LDL cholesterol, worsening hyperlipidemia, so they should be avoided to reduce cardiovascular risk.
A 70-year-old client is almost finished receiving her second unit of packed red blood cells. The client, who weighs 80 lb, has started complaining of being short of breath and now has crackles in the bases of her lungs. After slowing or stopping the transfusion, the most appropriate initial nursing action would be to:
- A. Raise the client's head and place her feet in a dependent position
- B. Notify the physician
- C. Place the client on 2 liters of O2 via nasal cannula
- D. Administer furosemide (Lasix) 20 mg IV push
Correct Answer: A
Rationale: Raising the head and placing feet in a dependent position reduces venous return and pulmonary congestion, addressing transfusion-related circulatory overload.
The nurse is teaching a client with a new diagnosis of Parkinson’s disease about levodopa/carbidopa (Sinemet). Which instruction should be included?
- A. Take the medication on an empty stomach.'
- B. Expect immediate improvement in symptoms.'
- C. Avoid driving until the medication’s effects are known.'
- D. Take the medication only when tremors are severe.'
Correct Answer: C
Rationale: Levodopa/carbidopa can cause dizziness or drowsiness, so avoiding driving until effects are known ensures safety. It is best taken with food, improvement is gradual, and it is taken regularly, not as needed.