Nokea
The nurse is caring for a client hospitalized with bipolar disorder, manic phase. Which of the following snacks would be best for the client?
- A. Potato chips
- B. Diet cola
- C. Apple
- D. Milkshake
Correct Answer: C
Rationale: An apple is a healthy, easy-to-eat snack that provides nutrition without excessive sodium (chips), caffeine (cola), or high calories (milkshake), suitable for a manic client needing stability.
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The nurse observes a client crying quietly. She has just experienced a spontaneous abortion at nine weeks' gestation. An appropriate response by the nurse would be:
- A. It must be God's will and probably is for the best.'
- B. This must be a difficult time for you. Would you like to talk about it?'
- C. I'm sure your other children will be a comfort for you.'
- D. Don't worry, you're still young. If I were you I'd just try again.'
Correct Answer: B
Rationale: This response is nontherapeutic because it belittles the client's response and gives a meaningless rationalization. This response acknowledges the client's feelings and demonstrates the therapeutic offering of self by the nurse. This response is nontherapeutic because it does not focus on the client's feelings and offers false reassurance. This response is nontherapeutic because it belittles the client's feelings and offers her advice.
A client with a history of a pituitary tumor is receiving Bromocriptine (Parlodel). The nurse should monitor the client for:
- A. Hypotension
- B. Hyperglycemia
- C. Weight gain
- D. Hair loss
Correct Answer: A
Rationale: Bromocriptine, a dopamine agonist, can cause hypotension due to vasodilation. Hyperglycemia, weight gain, and hair loss are not primary side effects.
An adolescent client with cystic acne has a prescription for Accutane (isotretinoin). Which lab work is needed before beginning the medication?
- A. Complete blood count
- B. Clean-catch urinalysis
- C. Liver profile
- D. Thyroid function test
Correct Answer: C
Rationale: Isotretinoin can cause liver toxicity, requiring a baseline liver profile to monitor for elevations in liver enzymes. CBC, urinalysis, and thyroid tests are not primary concerns.
A client is admitted to the labor room. She is dilated 4 cm. She is placed on electric fetal monitoring. Which of the following observations necessitates notifying the physician?
- A. Contractions every 2 minutes, lasting 100 seconds
- B. Fetal heart decelerations during a contraction
- C. Beat-to-beat variability between contractions
- D. Fetal heart decelerations at the beginning of contractions
Correct Answer: A
Rationale: These are tetanic in nature and can cause rupture of the uterus. The FHR decreases during contractions owing to vasoconstriction and should recover after the contraction. Beat-to-beat variability is a normal finding and demonstrates fetal well-being. The FHR may decrease at the beginning of a contraction owing to head compression.
At 32 weeks' gestation, a client is scheduled for a fetal activity test (nonstress test). She calls the clinic and asks the RN, 'How do I prepare for the test I am scheduled for?' The RN will most likely inform her of the following instructions to help prepare her for the test:
- A. You need to know that an IV is always started before the test.
- B. You will need to drink 6 to 8 glasses of water to fill your bladder.
- C. Do not eat any food or drink any liquids before the test is started.
- D. You will have to remain as still as you possibly can.
Correct Answer: D
Rationale: Any maternal activity can interfere with the results of the nonstress test, as movement may affect fetal heart rate tracings.