Nokea
Which cephalic presentation is most common during delivery of a neonate?
- A. Vertex
- B. Face
- C. Military
- D. Brow
Correct Answer: A
Rationale: Vertex presentation (A), with the head flexed and occiput leading, is the most common (95%) during delivery.
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The nurse is preparing a client with type 2 diabetes for a CT with contrast to evaluate diverticulitis with a possible mass. Which of the following medications on the client's medication list would be of concern to the nurse?
- A. fish oil
- B. warfarin (Coumadin)
- C. fluoxetine (Prozac)
- D. metformin (Glucophage)
Correct Answer: D
Rationale: Metformin should be held before and after contrast CT due to the risk of lactic acidosis if renal function is impaired by contrast dye.
The client with a history of diabetes insipidus is admitted with polyuria, polydipsia, and mental confusion. The priority intervention for this client is:
- A. Measure the urinary output
- B. Check the vital signs
- C. Encourage increased fluid intake
- D. Weigh the client
Correct Answer: B
Rationale: Mental confusion in diabetes insipidus may indicate severe dehydration or electrolyte imbalance, so checking vital signs is the priority to assess stability.
The nurse is assessing an older adult. The client does not appear to always understand the questions, sometimes answering incorrectly, and stares at the nurse's mouth rather than the nurse's eyes when the nurse is speaking. The client answers in an unusually loud voice. Which of the following impairments should the nurse suspect?
- A. Hearing impairment
- B. Cognitive impairment
- C. Vision impairment
- D. Anxiety
Correct Answer: A
Rationale: Staring at the mouth, answering loudly, and misunderstanding questions suggest hearing impairment (A). Cognitive impairment (B), vision impairment (C), and anxiety (D) do not typically present with these specific behaviors.
The client is scheduled to have an intravenous cholangiogram. Before the procedure, the nurse should assess the patient for:
- A. Shellfish allergies
- B. Reactions to blood transfusions
- C. Gallbladder disease
- D. Egg allergies
Correct Answer: A
Rationale: Iodinated contrast used in cholangiograms can cause reactions in patients with shellfish or iodine allergies due to potential cross-reactivity.
A 51-year-old client received a kidney transplant. Which of the following signs and symptoms indicates possible rejection of the kidney? Select all that apply.
- A. increased urine output
- B. increase in blood pressure
- C. weight gain
- D. pain in lower back
- E. decreased creatinine
Correct Answer: B,C,D
Rationale: Kidney rejection causes hypertension (B), fluid retention (weight gain, C), and graft pain (D). Decreased urine output (not increased) and elevated creatinine (not decreased) are typical.