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Which of the following clients is at greatest risk for postpartal hemorrhage?
- A. A gravida 1 para 1 with an uncomplicated delivery of a 7-pound infant
- B. A gravida 1 para 0 with a history of polycystic ovarian disease
- C. A gravida 2 para 2 with a history of low birth weight infants
- D. A gravida 4 para 3 with a Caesarean section
Correct Answer: D
Rationale: A gravida 4 para 3 with a Caesarean section is at higher risk for postpartal hemorrhage due to multiparity and surgical delivery, which can lead to uterine atony and increased bleeding risk.
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A newborn is to receive phototherapy for hyperbilirubinemia. Which nursing action is essential?
- A. Keep the infant NPO for two hours before the treatment.
- B. Ask the mother to stay away from the infant during the treatment.
- C. Monitor the client's pulse rate very carefully.
- D. Cover the baby's eyes during the treatment.
Correct Answer: D
Rationale: Covering the eyes protects the newborn's retinas from phototherapy light, a critical safety measure.
The nurse is assessing a client with a history of migraines. Which of the following symptoms would the nurse expect the client to report?
- A. Bilateral dull headache.
- B. Photophobia and nausea.
- C. Constant daily headache.
- D. Pain relieved by physical activity.
Correct Answer: B
Rationale: Migraines typically cause unilateral throbbing pain with photophobia and nausea due to neurological sensitivity. Bilateral dull pain (A) suggests tension headache, constant pain (C) indicates chronic headache, and activity (D) worsens migraines.
The wife of a man who is comatose following a head injury asks the nurse if she should visit him since he is unresponsive. How should the nurse reply initially?
- A. Explain that since he is unresponsive there is no need for her to be here
- B. Tell her that the nurse will call if there is any change
- C. Suggest that her presence is important even though he seems unaware
- D. Recommend that she ask his coworkers to visit
Correct Answer: C
Rationale: Presence of loved ones may provide comfort and stimulate awareness in comatose patients, supporting family involvement. Other responses discourage visitation.
Which teaching method is most effective when providing health care instructions to members of specific populations?
- A. teach-back
- B. video instructions
- C. written materials
- D. verbal explanation
Correct Answer: A
Rationale: The teach-back method ensures understanding by having patients repeat instructions in their own words, making it ideal for diverse populations with varying literacy levels. Video, written, or verbal methods may not confirm comprehension.
Epoetin alfa (Epogen) is prescribed for a client who is on dialysis. When teaching the client about the drug, the nurse should plan to include which information about the drug?
- A. The drug is given to help the kidneys produce urine.
- B. The drug is given because the kidneys can no longer get rid of waste products.
- C. The drug replaces natural erythropoietin, which can no longer be produced when the kidney is in failure.
- D. The drug is given to the client to improve athletic ability.
Correct Answer: C
Rationale: Epoetin alfa replaces erythropoietin, deficient in kidney failure, to stimulate red blood cell production, correcting anemia. It does not affect urine production, waste removal, or athletic performance.