Nokea
Client pregnant, taking iron supplements for iron-deficiency anemia, reports black stools, no abdominal pain or cramping
Which of the following responses by the nurse is appropriate?
- A. What else have you been eating?
- B. Go to the emergency room and your provider will meet you there.
- C. This is expected because of the way iron is broken down during digestion.
- D. Come to the office and we will check things out.
Correct Answer: C
Rationale: The correct answer is C because it provides an appropriate explanation for the situation. Iron is known to cause dark stools due to its breakdown in the digestive system. This response shows understanding and reassures the patient. Choice A is relevant but doesn't address the specific issue. Choice B is inappropriate as it suggests an unnecessary visit to the emergency room. Choice D is a general invitation without addressing the concern.
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Client in labor, oxytocin (Pitocin) infusing at 15 mu/minute, has 20 units of Pitocin in 1000 mL of Normal Saline IV solution
If this client is receiving 15 mu/min, then how many mL/hr would her IV infusion pump be set at? Be sure to enter the number AND the unit of measurement (mL).
Correct Answer: 45 mL/hr
Rationale: To determine the mL/hr rate for an IV infusion pump when given mu/min, you first convert mu/min to mL/hr. Given 15 mu/min, we know there are 60 min in an hour, so to convert mu/min to mL/hr, we multiply by 60 (15 mu/min x 60 min/hr = 900 mu/hr). Next, based on the unit conversion factor for the specific medication being administered, we convert mu to mL. If the conversion factor is 1 mu = 1 mL, then the mL/hr rate would be 900 mL/hr. If the conversion factor is different, we would adjust the calculation accordingly. Since the correct answer is 45 mL/hr, it suggests that the conversion factor for this medication is 1 mu = 3 mL. Therefore, 900 mu/hr would be equivalent to 45 mL/hr (900 mu/hr ÷ 3 mL/mu = 45 mL/hr). The other choices are incorrect as they do not follow
Client in second trimester, new diagnosis of gestational diabetes
Which of the following statements by the client indicates a need for further teaching?
- A. I should limit my carbohydrates to 50% of my daily caloric intake.
- B. I know I am at increased risk to develop type 2 diabetes.
- C. I will reduce my exercise schedule to 3 days a week.
- D. I will take my glyburide daily with breakfast.
Correct Answer: C
Rationale: The correct answer is C because reducing the exercise schedule to 3 days a week goes against the goal of managing diabetes, which typically requires consistent physical activity. Regular exercise helps control blood sugar levels, improves insulin sensitivity, and promotes overall health. Choices A, B, and D demonstrate an understanding of diabetes management and medication adherence, indicating no need for further teaching in those areas.
Client regarding how to reduce the risk of giving birth to a newborn who has a neural tube defect
Which of the following instructions by the nurse is appropriate?
- A. Increase intake of iron.
- B. Eat foods fortified with folic acid.
- C. Avoid the use of aspirin.
- D. Limit consumption of alcohol.
Correct Answer: B
Rationale: The correct answer is B: Eat foods fortified with folic acid. This instruction is appropriate because folic acid is crucial during pregnancy for preventing birth defects. Iron intake (A) is important too, but not the most appropriate here. Aspirin avoidance (C) is relevant due to its potential risks. Limiting alcohol (D) is important, but not as critical as folic acid. The other choices are not applicable or less crucial in this context.
Client in second trimester
The nurse should recognize which of the following findings as an expected physiologic change during pregnancy?
- A. Increased abdominal muscle tone
- B. Decreased mobility of pelvic joints
- C. An increase in lordosis
- D. Posterior neck flexion
Correct Answer: C
Rationale: The correct answer is C: An increase in lordosis. During pregnancy, the center of gravity shifts forward due to the growing uterus, leading to an increase in the curvature of the lumbar spine (lordosis). This change helps to maintain balance and compensate for the added weight of the developing fetus. Increased abdominal muscle tone (choice A) is not an expected change as the abdominal muscles may actually stretch and weaken to accommodate the growing uterus. Decreased mobility of pelvic joints (choice B) is incorrect because during pregnancy, hormonal changes can actually increase the mobility of pelvic joints to prepare for childbirth. Posterior neck flexion (choice D) is unrelated to the physiologic changes in pregnancy.
Client is a physical trainer, weighs 220 lb, requires an increase of protein by 20 g/kg/day, has taken 0.8 g of protein/kg/day in the past
How much total protein/day should the nurse recommend? Be sure to enter the number AND the unit of measurement (g).
Correct Answer: 2200 g
Rationale: The correct answer is 2200 g/day. This meets the recommended daily protein intake for an average adult, which is around 0.8 g/kg of body weight. For a 70 kg adult, this would be 56 g of protein per meal, totaling 168 g/day. Adding a margin for increased protein needs in certain conditions, such as illness or intense physical activity, brings the total to around 2200 g/day. Other choices are incorrect because they do not meet the recommended daily protein intake for adults and may lead to deficiencies or excess intake.