Nokea
A 25-year-old primigravida with type I diabetes mellitus.
The nurse explains to the client that her insulin needs will
- A. increase during pregnancy and decrease after delivery.
- B. decrease during pregnancy and increase after delivery.
- C. increase during pregnancy and remain increased after delivery.
- D. decrease during pregnancy and fluctuate after delivery.
Correct Answer: A
Rationale: Strategy: Think about each answer choice. (1) correct-needs increase during pregnancy due to hormonal interference in glucose metabolism (2) needs increase during pregnancy due to hormonal interference in glucose metabolism (3) insulin needs will decrease after delivery (4) needs increase during pregnancy
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The nurse working in a surgeon's office receives all of the following messages from the answering service. Which client should be called back first?
- A. An adult who had an inguinal hernia repair yesterday states that he is having trouble urinating.
- B. An adult who had an appendectomy yesterday says the pain medication makes her sleepy.
- C. An adult who had abdominal surgery two weeks ago wants to know if she can drive a car.
- D. An adult who had a laparoscopic cholecystectomy two days ago says the adhesive bands fell off the incisions.
Correct Answer: A
Rationale: Difficulty urinating post-hernia repair may indicate urinary retention, a potential complication requiring urgent attention. Other issues are less immediate.
The nurse is providing foot care instructions to a client with arterial insufficiency. The nurse would identify the need for additional teaching if the client stated
- A. I can only wear cotton socks.'
- B. I cannot go barefoot around my house.'
- C. I will trim corns and calluses regularly.'
- D. I should ask a family member to inspect my feet daily.'
Correct Answer: C
Rationale: I will trim corns and calluses regularly.' Clients who are elderly, have diabetes, and/or have vascular disease often have decreased circulation and sensation in one or both feet. Their vision may also be impaired. Therefore, they need to be taught to examine their feet daily or have someone else do so. They should wear cotton socks which have not been mended, and always wear shoes when out of bed. They should not cut their nails, corns, and calluses, but should have them trimmed by their provider, nurse, or another provider who specializes in foot care.
The nurse is caring for a client receiving chemotherapy.
- A. Which symptom should the nurse report immediately for a client receiving chemotherapy?
- B. Nausea and vomiting.
- C. A temperature of 100.8°F (38.2°C).
- D. Fatigue and weakness.
- E. Alopecia.
Correct Answer: B
Rationale: A temperature of 100.8°F indicates possible infection, a life-threatening complication in chemotherapy patients due to immunosuppression. Nausea, fatigue, and alopecia are expected side effects but less urgent.
The nurse is assessing a pregnant client in her third trimester. The parents are informed that the ultrasound suggests that the baby is small for gestational age (SGA). An earlier ultrasound indicated normal growth. The nurse understands that this change is most likely due to what factor?
- A. Sexually transmitted infection
- B. Exposure to teratogens
- C. Maternal hypertension
- D. Chromosomal abnormalities
Correct Answer: C
Rationale: Maternal hypertension. Pregnancy induced hypertension is a common cause of late pregnancy fetal growth retardation. Vasoconstriction reduces placental exchange of oxygen and nutrients.
An adult male calls his nurse neighbor and says he is having severe chest pain and feels as though something terrible is happening to him. He rates his pain as 10 on the 10-point scale. In addition to calling 911, what should the nurse recommend the man do now?
- A. Take an aspirin
- B. Lie flat
- C. Take some deep breaths
- D. Go to bed
Correct Answer: A
Rationale: Aspirin reduces clot formation in suspected myocardial infarction, improving outcomes, and should be taken immediately.