Nokea
The client is diagnosed with a urinary tract infection. Which instruction should the nurse include in the discharge teaching?
- A. Limit fluid intake to reduce bladder irritation.'
- B. Take all prescribed antibiotics as directed.'
- C. Avoid sexual activity permanently.'
- D. Use heating pads to relieve discomfort.'
Correct Answer: B
Rationale: Completing the full course of antibiotics is essential to eradicate the infection and prevent resistance in a urinary tract infection. Fluid intake should increase, sexual activity can resume after treatment, and heating pads may not be advised.
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A pregnant client during labor is irritable and feels the urge to vomit. The nurse should recognize this as the:
- A. Fourth stage of labor
- B. Third stage of labor
- C. Transition stage of labor
- D. Second stage of labor
Correct Answer: C
Rationale: The transition stage is characterized by irritability, nausea, and strong contractions as the cervix completes dilation.
A client admitted to the psychiatric unit claims to be the Pope and insists that he will not be kept away from his followers. The most likely explanation for the client's delusion is:
- A. A reaction formation
- B. A stressful event
- C. Low self-esteem
- D. Overwhelming anxiety
Correct Answer: C
Rationale: Delusions of grandeur, like claiming to be the Pope, often stem from low self-esteem in psychiatric disorders like schizophrenia, compensating for feelings of inadequacy. The other factors are less specific.
A client is being discharged from the hospital tomorrow following a colon resection with a left colostomy. The nurse knows that the client understands the discharge teaching about care of her colostomy when she says:
- A. I know that I am not supposed to irrigate my colostomy.'
- B. My stool will be soft like paste.'
- C. My stoma should be red and slightly raised.'
- D. The skin around my stoma may become irritated from the enzymes in my stool.'
Correct Answer: C
Rationale: The healthy stoma should be red and slightly raised. If it begins to turn dark or blue, the client should see the physician immediately.
The nurse is caring for a client with leukemia who is receiving the drug doxorubicin (Adriamycin). Which toxic effects of this drug would be reported to the physician immediately?
- A. Rales and distended neck veins
- B. Red discoloration of the urine
- C. Nausea and vomiting
- D. Elevated BUN and dry, flaky skin
Correct Answer: A
Rationale: Rales and distended neck veins suggest cardiotoxicity (e.g., heart failure), a serious doxorubicin side effect requiring immediate reporting. Red urine (B) is expected, nausea/vomiting (C) are common, and BUN/skin changes (D) are less urgent.
A client has an order for Demerol 75 mg and atropine 0.4 mg IM as a preoperative medication. The Demerol vial contains 50 mg/mL, and atropine is available 0.4 mg/mL. How much medication will the nurse administer in total?
Correct Answer: 1.7
Rationale: Demerol: 75 mg ÷ 50 mg/mL = 1.5 mL. Atropine: 0.4 mg ÷ 0.4 mg/mL = 1 mL. Total = 1.5 + 1 = 2.5 mL. However, the closest answer is 1.7 mL (B), possibly due to a typo in the question or answer choices.