Nokea
The nurse is conducting a health fair at a local high school on reducing high-risk behaviors. Which teaching should the nurse include in the presentation? Select all that apply.
- A. Always buckle up, even for a short trip.
- B. Use approved bike helmets for bike riding.
- C. Do not drive for one hour after drinking alcohol.
- D. Condoms offer full protection against sexually transmitted infections.
- E. Dive into untested waters with the hands fully extended over the head.
Correct Answer: A,B
Rationale: Seat belts and helmets reduce injury risk. Waiting one hour post-alcohol is insufficient, condoms don't fully protect against all STIs, and diving into untested waters is dangerous.
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The nurse has conducted a class for pregnant clients diagnosed with diabetes mellitus about the signs/symptoms of potential complications. The nurse determines that the teaching was effective if a client makes which statement?
- A. I should not have ultrasounds done because I am diabetic.
- B. I'm glad I don't have to worry about developing hypoglycemia while I am pregnant.
- C. I need to watch my weight for any sudden gains because I could develop what they call gestational hypertension.
- D. My insulin needs should decrease during the last 2 months because I will be using some of the baby's insulin supply.
Correct Answer: C
Rationale: A diabetic pregnant client has a higher incidence of developing gestational hypertension than the nondiabetic pregnant client does. Ultrasounds are done frequently during a diabetic pregnancy to check for congenital anomalies and to determine appropriate growth patterns. Hypoglycemia is a problem during pregnancy in the client diagnosed with diabetes mellitus and needs to be assessed throughout the pregnancy. Insulin needs will increase during the last trimester because of increased hormone levels that destroy circulating insulin.
Which of the following interventions is necessary before insertion of an arterial line into the radial artery?
- A. Ensure that the client does not need surgery
- B. Assess the client's grip strength
- C. Perform an Allen test
- D. Check a serum potassium level
Correct Answer: C
Rationale: Before inserting an arterial line into the radial artery, it is crucial to perform an Allen test. The Allen test assesses the collateral circulation to the hand by compressing both the radial and ulnar arteries. By occluding the radial artery and releasing the ulnar artery, the nurse can check if the ulnar artery can adequately supply blood to the hand if the radial artery is cannulated. This step ensures that there is adequate circulation to the hand post-insertion of the arterial line.
Choice A, ensuring that the client does not need surgery, is not directly related to the insertion of an arterial line and is not a necessary step before the procedure. Choice B, assessing grip strength, is not specific to the vascular status of the hand and does not provide information about the adequacy of collateral circulation. Choice D, checking a serum potassium level, is unrelated to the assessment of radial artery patency and collateral circulation, which are the primary concerns before arterial line insertion.
The nurse is providing home care instructions to a client recovering from an acute inferior myocardial infarction (MI) with recurrent angina. What instruction should the nurse provide to this client?
- A. Avoid sexual intercourse for at least 4 months.
- B. Replace sublingual nitroglycerin tablets yearly.
- C. Participate in an exercise program that includes overhead lifting and reaching.
- D. Recognize the adverse effects of acetylsalicylic acid (aspirin), which include tinnitus and hearing loss.
Correct Answer: D
Rationale: After an acute MI, many clients are instructed to take an aspirin daily. Adverse effects include tinnitus, hearing loss, epigastric distress, gastrointestinal bleeding, and nausea. Sexual intercourse usually can be resumed in 4 to 8 weeks after an acute MI if the primary health care provider agrees and if the client has been able to achieve traditional parameters such as climbing two flights of steps without chest pain or dyspnea. Clients should be advised to purchase a new supply of nitroglycerin tablets every 6 months. Expiration dates on the medication bottle should also be checked. Activities that include lifting and reaching over the head should be avoided because they reduce cardiac output.
The nurse is teaching a 28-year-old male client about testicular cancer. Which statement by the client indicates understanding of the nurse's teaching?
- A. Testicular cancer is one of the hardest cancers to treat and cure.
- B. Testicular cancer is the most common cancer in men ages 25-35.
- C. A lump larger than a quarter should be reported to my health care provider.
- D. The best time to perform testicular self-examination is just after bathing because the scrotum is more relaxed.
Correct Answer: D
Rationale: Testicular self-examination is best post-bathing due to scrotal relaxation. Testicular cancer is common in 15-35-year-olds but highly treatable, and any lump should be reported.
A 28-year-old client has just given birth. At one minute the baby appears healthy, with the exception of bluish hands. Which of the following would the nurse midwife pronounce?
- A. The Apgar score is 11.
- B. The Apgar score is 9.
- C. The Apgar score is 6.
- D. The Apgar score is 4.
Correct Answer: B
Rationale: The Apgar score assesses appearance, pulse, grimace, activity, and respiration, with a maximum of 10. Bluish hands indicate acrocyanosis, common in newborns, deducting 1 point from appearance, resulting in a score of 9 if other parameters are normal. Option A is impossible, and C and D are too low for a healthy baby.