Which of the following instructions should be included in the nurse's teaching regarding oral contraceptives?
- A. Weight gain should be reported to the physician.
- B. An alternate method of birth control is needed when taking antibiotics.
- C. If the client misses one or more pills, two pills should be taken per day for 1 week.
- D. Changes in the menstrual flow should be reported to the physician.
Correct Answer: B
Rationale: Antibiotics can reduce the effectiveness of oral contraceptives, necessitating an alternate method.
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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 client with sickle cell anemia is admitted to the labor and delivery unit during the first phase of labor. The nurse should anticipate the client's need for:
- A. Supplemental oxygen
- B. Fluid restriction
- C. Blood transfusion
- D. Delivery by Caesarean section
Correct Answer: A
Rationale: Sickle cell anemia increases oxygen demand during labor, often requiring supplemental oxygen.
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.
A client is admitted with suspected Legionnaires' disease. Which factor increases the risk of developing Legionnaires' disease?
- A. Treatment of arthritis with steroids
- B. Foreign travel
- C. Eating fresh shellfish twice a week
- D. Doing volunteer work at the local hospital
Correct Answer: A
Rationale: Steroid use increases the risk of Legionnaires' disease by suppressing the immune system, making individuals more susceptible to Legionella infection.
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.
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