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Which of the following postpartal clients is at greatest risk for 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 3 para 3 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 hemorrhage due to uterine atony from multiple pregnancies and surgical delivery.
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Which of the following is NOT a component of evidence-based practice?
- A. outcomes of research studies
- B. culturally competent care
- C. patient values
- D. clinical expertise
Correct Answer: B
Rationale: Evidence-based practice integrates research outcomes, patient values, and clinical expertise. Culturally competent care is important but not a core component of EBP.
A critically injured woman is rushed to the ER. She needs an immediate blood transfusion, and there is no time to crossmatch blood type. The nurse anticipates the physician will call for
- A. 1 unit of AB positive blood.
- B. 1 unit of O positive blood.
- C. 1 unit of AB negative blood.
- D. 1 unit of O negative blood.
Correct Answer: D
Rationale: O negative blood is the universal donor, safe for emergency transfusions without crossmatching, minimizing reaction risk.
The nurse is caring for a female client following the removal of the parathyroid glands. The client complains of a 'pins and needles' sensation and difficulty swallowing lunch. The nurse would expect which laboratory value to be abnormal?
- A. calcium
- B. potassium
- C. magnesium
- D. blood glucose
Correct Answer: A
Rationale: Parathyroidectomy can cause hypocalcemia, leading to paresthesia ('pins and needles') and dysphagia due to muscle dysfunction.
A 19-year-old male was prescribed sertraline (Zoloft) 3 weeks ago for depression. He calls the clinic today and tells the nurse that he has been feeling increasingly anxious and wants to stop taking the medication because it is not working. The best response for the nurse is
- A. You can stop taking the Zoloft, but let's make another appointment with your provider so you can try a different medication.'
- B. Increased anxiety is a normal side effect for the first few weeks of taking this medication. It will take several weeks to determine if it is working. Please keep taking it as prescribed.'
- C. Increased anxiety is not a normal side effect of Zoloft. What day this week can you come to the clinic to discuss this with your provider?'
- D. Try taking half the prescribed dose for the next week and see if that helps the feelings of anxiety.'
Correct Answer: B
Rationale: Increased anxiety is a common early side effect of SSRIs like sertraline, which typically subsides after a few weeks. The therapeutic effect takes 4-6 weeks. Continuing the medication and monitoring is appropriate.
If the nurse is providing education to a male client who is HIV positive, which of the following information should the nurse include? Select all that apply.
- A. Need to use condoms for every sexual encounter.
- B. Need to tell sexual or needle-sharing partners about HIV status.
- C. Signs and symptoms indicating increased viral load and infections.
- D. Importance of maintaining a healthy lifestyle.
- E. Availability of support groups.
Correct Answer: A,B,C,D,E
Rationale: HIV education includes condoms (A), disclosing status (B), monitoring symptoms (C), healthy lifestyle (D), and support groups (E) to manage disease and prevent transmission.