Nokea
The physician has ordered a homocysteine blood level on a client. The nurse recognizes that the results will be increased in a client with a deficiency in:
- A. Vitamin B12
- B. Vitamin C
- C. Vitamin A
- D. Vitamin E
Correct Answer: A
Rationale: Homocysteine levels rise with vitamin B12 deficiency, as B12 is needed for homocysteine metabolism, unlike other vitamins listed.
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A client develops mastitis in the postpartum period. Which of the following instructions does the nurse anticipate when notifying the physician? Select all that apply.
- A. Antibiotics for 7 to 10 days.
- B. Opioid analgesia.
- C. Alternating hot and cold compresses to relieve the pain.
- D. Discontinuation of breastfeeding.
- E. Continuation of breastfeeding.
Correct Answer: A,C,E
Rationale: Mastitis is typically treated with antibiotics (A) for 7-10 days to address the infection. Alternating hot and cold compresses (C) can help relieve pain and reduce inflammation. Continuation of breastfeeding (E) is encouraged to promote milk flow and prevent further complications, unless contraindicated. Opioid analgesia (B) is not typically required, and discontinuation of breastfeeding (D) is not recommended as it may worsen the condition.
A newborn is diagnosed with congenital syphilis. Classic signs of congenital syphilis are:
- A. Red papular rash, desquamation, white strawberry tongue
- B. Rhinitis, maculopapular rash, hepatosplenomegaly
- C. Red edematous cheeks, maculopapular rash on the trunk and extremities
- D. Epicanthal folds, low-set ears, protruding tongue
Correct Answer: B
Rationale: Congenital syphilis presents with rhinitis (‘snuffles'), maculopapular rash, and hepatosplenomegaly due to systemic infection.
An obstetric client is admitted with dehydration. Which IV fluid would be most appropriate for the client?
- A. .45 normal saline
- B. Dextrose 1% in water
- C. Lactated Ringer's
- D. Dextrose 5% in .45 normal saline
Correct Answer: C
Rationale: Lactated Ringer's is isotonic and effective for correcting dehydration in obstetric clients, replacing fluids and electrolytes.
A 6-month-old is hospitalized with symptoms of botulism. What aspect of the infant's history is associated with Clostridium botulinum infection?
- A. The infant sucks on his fingers and toes.
- B. The mother sweetens the infant's cereal with honey.
- C. The infant was switched to soy-based formula.
- D. The father recently purchased an aquarium.
Correct Answer: B
Rationale: Honey can contain Clostridium botulinum spores, which are a common cause of infant botulism in children under 12 months, as their digestive systems cannot eliminate the spores.
A client is receiving hospice and palliative care, including analgesia and other comfort measures. Which of the following indicates the client is undergoing life review? Select all that apply.
- A. The client looks through old photo albums.
- B. The client states that her analgesia is not adequate.
- C. The client reminisces about her children when they were young and her parenting skills.
- D. The client states that she is ready to die.
- E. The client states she does not want her children to have a funeral for her.
Correct Answer: A,C
Rationale: Looking at photos (A) and reminiscing about parenting (C) indicate life review, reflecting on past experiences. Other statements (B, D, E) relate to pain or end-of-life wishes.