Nokea
The nurse teaches a pregnant client that a high-risk symptom occurring at any time during pregnancy that needs to be reported immediately to a healthcare provider is:
- A. Constipation
- B. Urinary frequency
- C. Breast tenderness
- D. Abdominal pain
Correct Answer: D
Rationale: Abdominal pain may be an indication of early spontaneous abortion, preterm delivery, or a placental abruption, requiring immediate medical attention.
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A measurable outcome criterion in the nursing care of an adolescent with anorexia nervosa would be:
- A. Accepting her present body image
- B. Verbalizing realistic feelings about her body
- C. Having an improved perception of her body image
- D. Exhibiting increased self-esteem
Correct Answer: B
Rationale: This outcome criterion is inadequate because the term 'accepts' is not directly measurable. This outcome criterion is directly measurable because specific goal-related verbalizations can be heard and verified by the nurse. 'Improved perception of body image' is not directly measurable and is therefore open to many interpretations. Although long-term goals for the anorexic client should focus on increased self-esteem, this outcome criterion (as stated) does not include specific indicators or behaviors for which to observe.
The nurse would teach a male JOB client ways to minimize the risk of infection after eye surgery. Which of the following indicates the client needs further teaching?
- A. I will wash my hands before instilling eye medications.'
- B. I will wear sunglasses when going outside.'
- C. I will wear an eye patch for the first 3 postoperative days.'
- D. I will maintain the sterility of the eye medications.'
Correct Answer: C
Rationale: Eye patches are typically worn during sleep or naps, not constantly for 3 days, indicating a need for further teaching. The other options are correct preventive measures.
The client has an order for Garamycin (gentamicin) to be administered. Which lab test should be done before beginning the medication?
- A. Hematocrit
- B. Serum creatinine
- C. White cell count
- D. BUN
Correct Answer: B
Rationale: Gentamicin, an aminoglycoside, is nephrotoxic. Serum creatinine is monitored before administration to assess baseline kidney function, as impaired renal function increases toxicity risk. Hematocrit, white cell count, and BUN are less specific for gentamicin.
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 client is admitted with a diagnosis of placenta accreta. Which complication is most likely to occur?
- A. Maternal hemorrhage
- B. Fetal distress
- C. Preterm labor
- D. All of the above
Correct Answer: D
Rationale: Placenta accreta where the placenta abnormally adheres to the uterine wall increases the risk of maternal hemorrhage (during delivery) fetal distress (from placental dysfunction) and preterm labor (from interventions). All are potential complications.