Nokea
The nurse is caring for a client with a diagnosis of preterm labor. Which medication is most likely to be ordered?
- A. Betamethasone
- B. Terbutaline
- C. Magnesium sulfate
- D. All of the above
Correct Answer: D
Rationale: Betamethasone promotes fetal lung maturity terbutaline and magnesium sulfate are tocolytics to halt preterm contractions and magnesium may also provide neuroprotection. All are commonly ordered in preterm labor.
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Which client clinical manifestation during a bone marrow transplantation procedure alerts the nurse to the possibility of an adverse reaction?
- A. Fever
- B. Red colored urine
- C. Hypertension
- D. Shortness of breath
Correct Answer: D
Rationale: Shortness of breath may indicate an acute transfusion reaction (e.g., TRALI) during bone marrow transplantation, requiring immediate action. Fever (A), red urine (B), and hypertension (C) are less specific or expected.
The nurse would assess the client's correct understanding of the fertility awareness methods that enhance conception, if the client stated that:
- A. My sexual partner and I should have intercourse when my cervical mucosa is thick and cloudy.'
- B. At ovulation, my basal body temperature should rise about 0.5F.'
- C. I should douche immediately after intercourse.'
- D. My sexual partner and I should have sexual intercourse on day 14 of my cycle regardless of the length of the cycle.'
Correct Answer: B
Rationale: A slight rise in basal body temperature (about 0.5°F) after ovulation, due to progesterone, indicates correct understanding of fertility awareness.
The nurse is caring for a client with a history of Crohn’s disease. Which dietary recommendation is most appropriate?
- A. High-fiber diet
- B. Low-residue diet
- C. High-fat diet
- D. Low-protein diet
Correct Answer: B
Rationale: A low-residue diet reduces bowel irritation in Crohn’s disease, minimizing symptoms like diarrhea. High-fiber diets exacerbate symptoms, and high-fat or low-protein diets are not indicated.
When discussing the relationship between exercise and insulin requirements, a 26-year-old client with IDDM should be instructed that:
- A. When exercise is increased, insulin needs are increased
- B. When exercise is increased, insulin needs are decreased
- C. When exercise is increased, there is no change in insulin needs
- D. When exercise is decreased, insulin needs are decreased
Correct Answer: B
Rationale: Exercise decreased the blood sugar by promoting uptake of glucose by the muscles. Consequently, less insulin is needed to metabolize ingested carbohydrates. Extra food may be required for extra activity.
The client is admitted with a diagnosis of vasa previa. Which delivery method is most likely to be planned?
- A. Vaginal delivery
- B. Cesarean section
- C. Forceps-assisted delivery
- D. Vacuum-assisted delivery
Correct Answer: B
Rationale: Vasa previa with fetal vessels crossing the cervical os requires cesarean section to prevent vessel rupture and fetal exsanguination during vaginal delivery. Forceps or vacuum delivery increases risk.