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A client, gravida 1, para 0, in active labor, is becoming increasingly anxious. Which statement by the nurse will block therapeutic communication with the client?
- A. What concerns are you having now?
- B. Tell me how you are feeling.
- C. Everything is going just fine.
- D. You seem a little nervous.
Correct Answer: C
Rationale: Correct Answer: C
Rationale:
1. Choice A and B encourage the client to express their concerns and feelings, promoting therapeutic communication.
2. Choice D acknowledges the client's emotions, showing empathy and understanding.
3. Choice C dismisses the client's anxiety, invalidating their feelings, hindering communication.
Summary:
Choices A, B, and D promote open communication and empathy, while choice C ignores the client's anxiety, making it the incorrect choice.
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A nurse is performing a routine physical examination on an adolescent client who asks, 'Why do I have to use a condom if my girlfriend is on the pill?' Which of the following is the most appropriate response by the nurse?
- A. You need to use two forms of birth control so if one fails you have a second form of protection against pregnancy.
- B. Using a condom allows you to share the responsibility for birth control.
- C. Oral contraceptives are less than 99 percent effective in adolescents. Therefore, a second form of contraception is needed.
- D. Oral contraceptives are highly effective in preventing pregnancy but do not prevent sexually transmitted diseases.
Correct Answer: D
Rationale: The correct answer is D. The nurse should explain that while oral contraceptives are highly effective in preventing pregnancy, they do not protect against sexually transmitted diseases (STDs). This is important because even if the girlfriend is on the pill, using a condom is necessary to prevent STD transmission. Adolescents are at higher risk for STDs, so it is crucial to emphasize the importance of dual protection. Choice A is incorrect as it does not specifically address the risk of STD transmission. Choice B is incorrect because it focuses on shared responsibility rather than the health implications of using a condom. Choice C is incorrect as it emphasizes the effectiveness of oral contraceptives rather than the need for STD protection.
A client at ten weeks gestation tells the nurse that she has been having 'morning sickness.' The nurse advises the client to eat foods that are easy to digest and low in fat. Which is the rationale for the nurse's instruction?
- A. A low-fat diet increases peristalsis,which reduces the food volume in the stomach
- B. A low-fat diet is digested faster and leaves less in the stomach that can be vomited
- C. Easily digested foods provide a better balance of fluids and electrolytes, resulting in less nausea and vomiting
- D. Easily digested foods are less likely to cause relaxation of the cardiac sphincter, which causes regurgitation and vomiting
Correct Answer: B
Rationale: The correct answer is B: A low-fat diet is digested faster and leaves less in the stomach that can be vomited. During pregnancy, hormonal changes can lead to morning sickness. Eating foods that are low in fat helps reduce the workload on the digestive system, allowing for quicker digestion. This means there is less food remaining in the stomach that could potentially trigger vomiting. Therefore, advising the client to eat low-fat foods can help alleviate morning sickness symptoms.
A: Incorrect. While a low-fat diet may aid in digestion, it does not specifically increase peristalsis to reduce food volume in the stomach.
C: Incorrect. While easily digested foods can be beneficial, the primary focus in this scenario is on reducing fat intake for faster digestion.
D: Incorrect. The issue of cardiac sphincter relaxation and vomiting is not directly related to the advice given by the nurse.
A nurse is preparing a room for the admission of a client with sickle cell anemia who is in vasoocclusive crisis. Which type of equipment should the nurse place in the client's room?
- A. Wheelchair with adjustable leg rests
- B. A radio and age-appropriate reading materials
- C. Extra blankets and pillows
- D. Blood transfusion equipment
Correct Answer: D
Rationale: The correct answer is D: Blood transfusion equipment. In a vasoocclusive crisis, the client with sickle cell anemia may require blood transfusions to improve oxygen delivery to tissues. Having blood transfusion equipment readily available in the client's room ensures prompt initiation of treatment. Wheelchair (A) and comfort items like extra blankets and pillows (C) are important but not essential during a vasoocclusive crisis. A radio and reading materials (B) are not directly related to the client's immediate medical needs.
A nurse is reviewing discharge teaching with the parents of a child who has pediculosis.Which of the following should the nurse include in the teaching?
- A. "Children can share scarves and coats ,but not hats or combs."'
- B. "Household pets can carry and transmit lice to people."'
- C. "After washing clothing,hang clothes outside to dry."'
- D. "Seal nonwashable items in plastic bags for 14 days."'
Correct Answer: D
Rationale: The correct answer is D. The nurse should include sealing nonwashable items in plastic bags for 14 days in the teaching for pediculosis. This is important to prevent reinfestation as lice can survive for up to 48 hours without a host. By sealing items in plastic bags for 14 days, any remaining lice or eggs will die off.
Choice A is incorrect because lice can be transmitted through shared hats and combs, not just scarves and coats. Choice B is incorrect as lice do not live on household pets. Choice C is incorrect as hanging clothes outside will not effectively eliminate lice.
An hour after delivery, a 4000 gram infant exhibits pallor, jitteriness, a blood sugar level of 40 gm/dL, irritability and periodic apnea. Which maternal condition could be the cause of the newborn's symptoms?
- A. Drug addiction
- B. Pregnancy-induced hypertension
- C. TORCH infection
- D. Gestational diabetes
Correct Answer: D
Rationale: The correct answer is D: Gestational diabetes. Infants born to mothers with gestational diabetes are at risk for hypoglycemia due to excessive production of insulin in response to maternal hyperglycemia. This causes the infant's blood sugar level to drop, leading to symptoms such as pallor, jitteriness, irritability, and apnea. The maternal condition directly affects the newborn's blood sugar levels, explaining the infant's symptoms.
Choice A: Drug addiction does not directly cause hypoglycemia in the newborn.
Choice B: Pregnancy-induced hypertension would not typically result in hypoglycemia in the newborn.
Choice C: TORCH infections are unlikely to cause the specific symptoms described in the newborn.
In summary, only gestational diabetes directly affects the newborn's blood sugar levels, leading to the observed symptoms.