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The labor and delivery nurse expects which clients to be at high risk for amniotic fluid embolus (AFE)? Select all that apply.
- A. a 27-year-old client with preeclampsia
- B. a healthy 23-year-old anticipating a vaginal delivery
- C. a 42-year-old expecting her second child via cesarean section
- D. a 32-year-old client with diabetes anticipating induced labor
Correct Answer: A,C,D
Rationale: Preeclampsia, cesarean section, and induced labor increase AFE risk due to uterine trauma or hyperstimulation. A healthy vaginal delivery has lower risk.
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A community health nurse is preparing a lecture on lifestyle and risk factors for a college-age audience. The nurse understands that which causes of death are the most common among this age group?
- A. HIV, suicide, unintentional injuries
- B. suicide, cancer, unintentional injuries
- C. suicide, unintentional injuries, homicide
- D. homicide, unintentional injuries, heart disease
Correct Answer: C
Rationale: Unintentional injuries, suicide, and homicide are the top causes of death in college-age individuals.
The nurse is providing discharge instructions to the mother of an 8-year-old child who had a tonsillectomy. The mother tells the nurse that the child loves tacos and asks when the child can safely eat one. To prevent complications of the surgical procedure, what should be the appropriate response to the mother?
- A. In 1 week.
- B. In 3 weeks.
- C. Six days after surgery.
- D. When the primary health care provider says it is okay.
Correct Answer: B
Rationale: Rough or scratchy foods, as well as spicy foods, are to be avoided for 3 weeks after a tonsillectomy. Citrus juices that irritate the throat should be avoided for 10 days. Red liquids are avoided because they will give the appearance of blood if the child vomits. The mother is instructed to add full liquids on the second day and soft foods as the child tolerates them.
A client being discharged from the hospital will be taking warfarin sodium at home on a daily basis. The nurse has provided instructions to the client about the medication and determines that further teaching is needed if the client makes which statement?
- A. I need to have a prothrombin time checked in 2 weeks.
- B. This medicine thins my blood and allows me to clot more slowly.
- C. I need to increase the intake of foods high in vitamin K in my diet.
- D. I need to report any increased bleeding or bruising to my doctor.
Correct Answer: C
Rationale: Warfarin sodium is an oral anticoagulant that is used mainly to prevent thrombotic events, such as thrombophlebitis, pulmonary embolism, and embolism formation caused by atrial fibrillation or other disorders. Oral anticoagulants prolong the clotting time and are monitored by the prothrombin time and the international normalized ratio (INR). Client education should include signs and symptoms of adverse effects and dietary limitations such as limiting foods high in vitamin K (e.g., leafy green vegetables, liver, cheese, egg yolks) as prescribed because these increase clotting times.
The community health nurse teaches a group of females how to prevent pelvic inflammatory disease (PID). What instruction should the nurse include?
- A. To douche monthly
- B. To avoid unprotected intercourse
- C. To use only ultra-low dose oral contraceptive pills
- D. To consult with a gynecologist regarding the placement of an intrauterine device (IUD)
Correct Answer: B
Rationale: PID is an infection of the pelvis. The primary prevention of PID includes avoiding unprotected intercourse. Douching leads to a higher risk for PID. It is believed that high hormonal doses may decrease risk of PID, but ultra-low doses will not. The use of an IUD may also increase the risk for PID.
The nurse is providing home care dietary instructions to a client who has been hospitalized for pancreatitis. Which food should the nurse instruct the client to avoid to prevent recurrence?
- A. Chili
- B. Bagels
- C. Lentil soup
- D. Watermelon
Correct Answer: A
Rationale: Pancreatitis involves inflammation of the pancreas, and spicy foods like chili can stimulate pancreatic secretions, potentially triggering a recurrence. The client should eat small, frequent meals that are high in protein, low in fat, and moderate to high in carbohydrates. Bagels, lentil soup, and watermelon are generally bland and acceptable.