Nokea
The teaching plan for a postpartum client who is about to be discharged should include which of the following instructions?
- A. It is normal for your breasts to be tender. You should call the physician if you also have redness and fatigue.
- B. Because your baby was delivered vaginally, you might have to urinate more frequently.
- C. It is normal to run a low-grade temperature for a few days. If it is higher than 100°F, call your physician.
- D. Be sure to call your physician if your vaginal discharge becomes bright red.
Correct Answer: D
Rationale: The vaginal discharge after birth is called lochia, and it changes from red (rubra) to serosa (clear) on the third postpartum day. If it returns to red or contains clots, it could signal impending hemorrhage or infection and the physician should be notified.
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Who should receive the hepatitis A vaccine?
- A. children who are 18 months of age
- B. infants, who should receive the vaccination at birth
- C. people who travel to other countries
- D. individuals who might come into contact with blood
Correct Answer: C
Rationale: Hepatitis A is for individuals who travel or persons with chronic liver disease. Infants receive the hepatitis B vaccine at birth. DTaP is administered at 18 months of age. Individuals who come into contact with blood should be immunized against hepatitis B.
Which of the following solutions is routinely used to flush an IV device before and after the administration of blood to a client?
- A. 0.9% sodium chloride
- B. 5% dextrose in water solution
- C. sterile water
- D. Heparin sodium
Correct Answer: A
Rationale: Normal saline (0.9% sodium chloride) is isotonic and safe for flushing IV lines before and after blood administration, preventing cell lysis or clotting.
Fat emulsions are frequently administered as a part of total parenteral nutrition. Which statement is true regarding fat emulsions?
- A. They have a high energy-to-fluid-volume ratio.
- B. Even though hypertonic, they are well tolerated.
- C. They are a basic solution secondary to the addition of sodium hydroxide (NaOH).
- D. The pH is alkaline, making them compatible with most medications.
Correct Answer: A
Rationale: They have a high energy-to-fluid-volume ratio. Fat emulsions are formulated in 10%, 20%, and 30% solutions and supply 1.1, 2, and 3 kilocalories respectively for each milliliter. A milliliter of 5% dextrose only supplies 0.17 kilocalories. Choices 2, 3, and 4 are incorrect because fat emulsions are essentially pH neutral and isotonic.
To improve overall health, the nurse should place highest priority on assisting a client to make lifestyle changes for which of the following habits?
- A. Drinking a six-pack of beer each day
- B. Eating an occasional chocolate bar
- C. Exercising twice a week
- D. Using relaxation exercises to deal with stress
Correct Answer: A
Rationale: Daily heavy alcohol consumption poses significant health risks (liver disease, cardiovascular issues), making it the highest priority for lifestyle change.
A client asks the nurse if all donor blood products are cross-matched with the recipient to prevent a transfusion reaction. Which of the following always requires cross-matching?
- A. Packed red blood cells
- B. Platelets
- C. Plasma
- D. Granulocytes
Correct Answer: A
Rationale: Packed red blood cells require cross-matching due to their antigens and antibodies, unlike platelets, plasma, or granulocytes, which do not contain red cells.