Nokea
The nurse is teaching a client with a history of osteoporosis about dietary modifications. The nurse should tell the client to increase intake of:
- A. Calcium-rich foods
- B. High-fiber foods
- C. Low-fat foods
- D. High-protein foods
Correct Answer: A
Rationale: Calcium-rich foods strengthen bones and help prevent further bone loss in osteoporosis, a critical dietary modification.
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A 34-year-old client who is gravida 1, para 0 has a history of infertility and conceived this pregnancy while taking fertility drugs. She is at 32 weeks' gestation and is carrying triplets. She is complaining of low back pain and a feeling of pelvic pressure. Her cervical exam reveals a long, closed cervix. The nurse notes that the client is experiencing mild uterine contractions every 7-8 minutes after the nurse has placed her on the fetal monitor. Her condition should indicate that:
- A. Her cervix shows she will likely deliver soon
- B. The nurse should not be alarmed because mild uterine activity is common at 32 weeks' gestation
- C. She may be in preterm labor because this is more common with multiple pregnancies
- D. She most likely has a urinary tract infection (UTI) because this is common with pregnancy
Correct Answer: C
Rationale: Rhythmical contractions in conjunction with low back pain and pelvic pressure at 32 weeks in a woman carrying triplets are of great concern, indicating possible preterm labor, which is more common in multiple pregnancies.
The nurse caring for a client in shock recognizes that the glomerular filtration rate of the kidneys will fail if the client's mean arterial pressure falls below which of the following levels?
- A. 140
- B. 120
- C. 100
- D. 80
Correct Answer: D
Rationale: A mean arterial pressure (MAP) below 80 mmHg compromises renal perfusion, leading to glomerular filtration failure. Higher MAPs (A, B, C) maintain adequate kidney function.
The nurse is caring for a client with a diagnosis of abruptio placenta. Which intervention is most appropriate?
- A. Monitor fetal heart tones
- B. Administer tocolytics
- C. Place the client in Trendelenburg position
- D. Administer antibiotics
Correct Answer: A
Rationale: Abruptio placenta can cause fetal hypoxia making fetal heart tone monitoring critical to assess fetal well-being. Tocolytics are contraindicated Trendelenburg may worsen bleeding and antibiotics are not indicated unless infection is present.
A female client has been treated since childhood for mitral valve prolapse. The antibiotic of choice for her during pregnancy would be:
- A. Sulfa
- B. Tetracycline
- C. Hydralazine
- D. Erythromycin
Correct Answer: D
Rationale: Sulfa is a teratogen and will cause kernicterus. Tetracycline is a teratogen and will affect tooth development. Hydralazine is not an antibiotic but a calcium channel blocker. Erythromycin is safe during pregnancy and can be used when the client is allergic to penicillin.
The nurse is assessing an adult female client for hypovolemia.
- A. Hematocrit 55%
- B. Potassium 5.0 mEq/L
- C. Urine specific gravity 1.016
- D. BUN 18 mg/dL
Correct Answer: A
Rationale: Elevated hematocrit (55%) indicates hemoconcentration due to fluid loss in hypovolemia. Potassium (B) and BUN (D) are within normal ranges, and urine specific gravity (C) is normal, not elevated as expected in hypovolemia.