Nokea
Client in second trimester, new diagnosis of gestational diabetes
Which statement by the client indicates a need for further teaching?
- A. I should limit my carbohydrates to 50% of caloric intake.
- B. I will take my glyburide daily with breakfast.
- C. I will reduce my exercise schedule to 3 days a week.
- D. I know I am at increased risk to develop type 2 diabetes.
Correct Answer: C
Rationale: The correct answer is C because reducing the exercise schedule to 3 days a week contradicts the importance of regular physical activity in managing diabetes. Regular exercise helps improve insulin sensitivity and control blood sugar levels. Limiting carbohydrates to 50% of caloric intake (choice A) is a recommended dietary guideline for diabetes management. Taking glyburide daily with breakfast (choice B) indicates adherence to medication therapy. Knowing about the increased risk of developing type 2 diabetes (choice D) shows awareness of the condition.
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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.
Adult patient, physician orders Magnesium 4 gms loading dose to infuse over 30 minutes at 0500, then infuse a maintenance dose of 1 gram/hr, pharmacy sends 80 Gms in 1000 mL of LR
What would the nurse set the pump for the loading dose at 5 Am? Be sure to enter the number AND the unit of measurement (mL).
Correct Answer: 200 mL/hr
Rationale: The correct answer is 200 mL/hr. At 5 AM, the nurse would set the pump for the loading dose based on the prescribed rate per hour. By setting the pump at 200 mL/hr, the patient will receive the intended dose over the specified time. Choices A-G are incorrect as they do not align with the standard dosing calculations for the loading dose at 5 AM.
Client possible ectopic pregnancy at 8 weeks of gestation
Which of the following findings should the nurse expect?
- A. Pelvic pain
- B. Severe nausea and vomiting
- C. Copious vaginal bleeding
- D. Uterine enlargement greater than expected for gestational age
Correct Answer: A
Rationale: The correct answer is A: Pelvic pain. This finding is indicative of ectopic pregnancy, where the fertilized egg implants outside the uterus, often causing pelvic pain due to fallopian tube stretching or rupture. Severe nausea and vomiting (B) can occur in normal pregnancy but are not specific to ectopic pregnancy. Copious vaginal bleeding (C) is more commonly seen in miscarriage. Uterine enlargement greater than expected for gestational age (D) would be expected in a normal intrauterine pregnancy, not in ectopic pregnancy.
Client at 28 weeks of gestation, history of one elective abortion at 9 weeks, birth of twins at 36 weeks, spontaneous abortion at 15 weeks
According to the GTPAL system, which of the following describes her present parity?
- A. 4-0-0-2-2
- B. 4-2-0-2-2
- C. 4-0-2-2-2
- D. 4-0-1-2-2
Correct Answer: D
Rationale: According to the GTPAL system, "G" represents the total number of pregnancies. In this case, the correct answer is D (4-0-1-2-2) because it indicates the woman has had 4 pregnancies, 0 term births, 1 preterm birth, 2 living children, and 2 abortions/miscarriages. This is the correct interpretation of her present parity. Choices A, B, and C have incorrect numbers for preterm births, living children, or abortions/miscarriages, making them incorrect.
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.