Nokea
Written instructions to pregnant women include instructions to perform Kegel exercises. One of the women asks the nurse why these exercises are important. The nurse should reply that the purpose of these exercises is to:
- A. increase circulation to the uterus.
- B. strengthen the muscles of the pelvic floor.
- C. prepare the breasts for nursing.
- D. condition the pregnant woman for the 'work' of childbirth.
Correct Answer: B
Rationale: Kegel exercises strengthen pelvic floor muscles, supporting bladder control and aiding postpartum recovery, directly addressing their purpose.
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The nurse is caring for a client with type 1 diabetes mellitus who is reporting abdominal pain and weakness. The client has a fruity odor to the breath and rapid, deep respirations. Which of the following actions should the nurse take? Select all that apply.
- A. Instruct the client to breathe into a paper bag
- B. Check the client's capillary blood glucose level.
- C. Place the client on a continuous cardiac monitor.
- D. Prepare the client for an IV infusion of regular insulin.
- E. Gather supplies for an IV bolus of 0.9% sodium chloride
Correct Answer: B,C,D,E
Rationale: Symptoms suggest diabetic ketoacidosis (DKA). Checking glucose confirms hyperglycemia, cardiac monitoring detects arrhythmias from electrolyte imbalances, IV insulin corrects hyperglycemia, and saline bolus addresses dehydration. Breathing into a paper bag is for hyperventilation from anxiety, not DKA.
The nurse is reviewing teaching with the parents of a child who has tinea capitis (ringworm of the scalp) and is newly prescribed griseofulvin oral suspension and 1% selenium sulfide shampoo. Which statement by the child's parent requires the nurse to intervene?
- A. I will discontinue the griseofulvin once the ringworm stops itching and the scales go away.
- B. I will give the griseofulvin suspension to my child after consumption of high-fat food, like ice cream.
- C. I will monitor my child for increased sensitivity to sunlight while taking griseofulvin.
- D. I will wash my child's scalp a few times per week with the medicated shampoo.
Correct Answer: A
Rationale: Griseofulvin requires a full course (6-8 weeks) to eradicate tinea capitis, even if symptoms resolve, to prevent recurrence. High-fat foods enhance absorption, photosensitivity is a side effect, and shampoo use a few times weekly is appropriate.
The nurse is collecting data on a 2-day-old infant with suspected Hirschsprung disease. Which findings should the nurse anticipate? Select all that apply.
- A. Bright red bleeding from anus
- B. Distended abdomen
- C. Has not passed stool (meconium)
- D. Nonbilious vomiting
- E. Refuses to feed
Correct Answer: B,C,D
Rationale: Hirschsprung disease causes intestinal obstruction, leading to a distended abdomen, failure to pass meconium, and nonbilious vomiting. Bright red bleeding suggests other causes (e.g., fissure). Feeding refusal is less specific.
The nurse is caring for a child who has had a tonsillectomy. Which of the following are appropriate nursing interventions? Select all that apply.
- A. Anticipate ear pain and give acetaminophen as needed
- B. Educate parents to expect the child to develop bad breath postoperatively
- C. Encourage the child to drink cold liquids through a straw
- D. Notify the health care provider about frequent, increased swallowing
- E. Use an oral suction device regularly to remove secretions from the back of the throat
Correct Answer: A,B,D
Rationale: Ear pain is common post-tonsillectomy due to referred pain, treated with acetaminophen. Bad breath is expected from healing tissue. Frequent swallowing may indicate bleeding, requiring provider notification. Cold liquids are soothing but straws risk trauma. Routine suctioning is unnecessary and risky.
The nurse is caring for a client with partial hearing loss. Which of the following actions will promote effective communication? Select all that apply.
- A. Dim lights to prevent overstimulation
- B. Directly face the client when speaking
- C. Ensure hearing aids are properly applied
- D. Provide written information to supplement conversation
- E. Raise voice to speak loudly to the client
Correct Answer: B,C,D
Rationale: Facing the client aids lip-reading, properly applied hearing aids optimize hearing, and written information reinforces verbal communication. Dimming lights may hinder lip-reading, and shouting distorts speech.