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NEW QUESTION # 380
A female client at 36 weeks' gestation is experiencing preterm labor. Her physician has prescribed two doses of betamethasone 12 mg IM q24h. The nurse explains that she is receiving this drug to:
- A. Promote fetal lung maturation
- B. Treat fetal respiratory distress syndrome
- C. Increase uteroplacental circulation
- D. Prevent uterine infection
Answer: A
Explanation:
(A) Respiratory distress syndrome occurs in the newborn, not the fetus. It may be treated postnatally with surfactant therapy. (B) Betamethasone is a corticosteroid, not an anti-infective drug; therefore, its use would not prevent uterine infection. (C) Betamethasone binds with glucocorticoid receptors in alveolar cells to increase production of surfactant, thus increasing lung maturity in the preterm fetus. (D) Betamethasone does not affect uteroplacental circulatory exchange.
NEW QUESTION # 381
A postpartum client complains of rectal pressure and severe pain in her perineum; this may be indicative of:
- A. Afterbirth pains
- B. Cystitis
- C. A hematoma of the vagina or vulva
- D. Constipation
Answer: C
Explanation:
Explanation
(A) Afterbirth pains are a common complaint in the postpartum client, but they are located in the uterus. (B) Constipation may cause rectal pressure but is not usually associated with "severe pain." (C) Cystitis may cause pain, but the location is different. (D) Hematomas are frequently associated with severe pain and pressure.
Further assessments are indicated for this client.
NEW QUESTION # 382
Clients receiving antipsychotic drug therapy will often exhibit extrapyramidal side effects that are reversible with which of the following agents ordered by the physician?
- A. Anticholinergics
- B. Phenothiazines
- C. Tricyclic agents
- D. Anti-Parkinsonian drugs
Answer: A
Explanation:
(A) This answer is incorrect. Phenothiazines are antipsychotic drugs and produce the symptoms. (B) This answer is correct. Anticholinergic agents are often used prophylactically for extrapyramidal symptoms. They balance cholinergic activity in the basal ganglia of the brain. (C) This answer is incorrect. Anti- Parkinsonian drugs would increase the symptoms. (D) This answer is incorrect. Tricyclic agents are used for symptoms of depression.
NEW QUESTION # 383
A male client has been hospitalized with congestive heart failure. Medical management of heart failure focuses on improving myocardial contractility. This can be achieved by administering:
- A. Nitroglycerin (Nitrol) 1 inch topically every 4 hours
- B. Furosemide (Lasix) 40 mg po every morning
- C. Digoxin (Lanoxin) 0.25 mg po every day
- D. O22 L/min via nasal cannula
Answer: C
Explanation:
(A) Digoxin is a cardiac glycoside given to clients in heart failure to improve their myocardial contractility. (B) Furosemide is a loop diuretic given to clients in heart failure to promote diuresis. (C) O2is given to clients in heart failure to increase oxygenation and to prevent or treat hypoxemia. (D) Nitroglycerin is a nitrate given to clients in heart failure to increase their cardiac output by decreasing the peripheral resistance that the left ventricle must pump against.
NEW QUESTION # 384
Which of the following risk factors associated with breast cancer would a nurse consider most significant in a client's history?
- A. Nulliparity
- B. Maternal family history of breast cancer
- C. Early menopause
- D. Menarche after age 13
Answer: B
Explanation:
Explanation/Reference:
Explanation:
(A) Women who begin menarche late (after 13 years old) have a lower risk of developing breast cancer than women who have begun earlier. Average age for menarche is 12.5 years. (B) Women who have never been pregnant have an increased risk for breast cancer, but a positive family history poses an even greater risk. (C) A positive family history puts a woman at an increased risk of developing breast cancer. It is recommended that mammography screening begin 5 years before the age at which an immediate female relative was diagnosed with breast cancer. (D) Early menopause decreases the risk of developing breast cancer.
NEW QUESTION # 385
The postpartum nurse should include which of the following instructions to breast-feeding mothers?
- A. Daily caloric intake should be increased by 500 cal.
- B. Wash the nipples with soap and water before and after each feeding.
- C. Breast milk is totally digestible by the baby because it contains lactose.
- D. Limit feeding times for several days to avoid nipple soreness.
Answer: A
Explanation:
Explanation/Reference:
Explanation:
(A) Limiting initial feeding times will only delay nipple soreness as well as the establishment of the letdown reflex, thus encouraging engorgement from clogged ducts and ductules. (B) Soap should be avoided because it may be excessively drying, predisposing nipples to cracking. (C) For optimal milk production, an additional 500 kcal over maintenance levels are needed daily. (D) Lipase, not lactose, emulsifies the fat in breast milk, making it almost totally digestible by infants.
NEW QUESTION # 386
Following a fracture of the left femur, a client develops symptoms of osteomyelitis. During the acute phase of osteomyelitis, nursing care is directed toward:
- A. Moving or turning the client's left leg carefully to minimize pain and discomfort
- B. Instituting physical therapy to ensure restoration of optimal functioning of the leg
- C. Providing the client with a high-protein, high-fiber diet to promote healing
- D. Allowing the client out of bed only in a wheelchair or gurney to minimize weight bearing on the left leg
Answer: A
Explanation:
Section: Questions Set D
Explanation:
(A) Any movement of his affected limb will cause discomfort to the child. (B) No weight bearing will be allowed until healing is well underway to avoid pathological fractures. (C) The child will be anorexic and may experience vomiting. Diet should be simple and high caloric until appetite returns and symptoms subside. (D) Physical therapy is instituted only after infection subsides.
NEW QUESTION # 387
A client's behavior is annoying other clients on the unit. He is meddling with their belongings and dominating the group. The best approach by the nurse is to:
- A. Seclude him in his room.
- B. Ignore him and tell the other clients that these behaviors are due to his illness and that they should understand.
- C. Set limits on his behavior.
- D. Have his medication increased.
Answer: C
Explanation:
Section: Questions Set D
Explanation:
(A) This action by the nurse would be punitive. (B) Consistent limit setting will help the client to know what is acceptable behavior. (C) This action is not within the nurse's scope of practice. (D) This could be dangerous to the client and to others and violates other clients' rights.
NEW QUESTION # 388
The nurse teaches a male client ways to reduce the risks associated with furosemide therapy. Which of the following indicates that he understands this teaching?
- A. "I'll be sure to restrict my fluid intake to four or five glasses a day."
- B. "I'll be sure to walk at least 2-3 blocks every day."
- C. "I'll be sure to rise slowly and sit for a few minutes after lying down."
- D. "I'll be sure not to take any more aspirin while I am on this drug."
Answer: C
Explanation:
(A) This response will help to prevent the occurrence of postural hypotension, a common side effect of this drug and a common reason for falls. (B) Although walking is an excellent exercise, it is not specific to the reduction of risks associated with diuretic therapy. (C) Clients on diuretic therapy are generally taught to ensure that their fluid intake is at least 2000-3000 mL daily, unless contraindicated. (D) Aspirin is a safe drug to take along with furosemide.
NEW QUESTION # 389
A woman diagnosed with multiple sclerosis is disturbed with diplopia. The nurse will teach her to:
- A. Limit activities which require focusing (close vision)
- B. Wear a patch over one eye
- C. Use artificial tears
- D. Take more frequent naps
Answer: B
Explanation:
(A)
Limiting activities requiring close vision will not alleviate the discomfort of double vision.
(B)
Frequent naps may be comforting, but they will not prevent double vision. (C) Artificial tears are necessary in the absence of a corneal reflex, but they have no effect on diplopia.
(D)
An eye patch over either eye will eliminate the effects of double vision during the time the eye patch is worn. An eye patch is safe for a person with an intact corneal reflex.
NEW QUESTION # 390
The nurse notes scattered crackles in both lungs and 1+ pitting edema when assessing a cardiac client.
The physician is notified and orders furosemide (Lasix) 80 mg IV push stat. Which of the following diagnostic studies is monitored to assess for a major complication of this therapy?
- A. 12-Lead ECG
- B. Arterial blood gases
- C. Complete blood count
- D. Serum electrolytes
Answer: D
Explanation:
Explanation/Reference:
Explanation:
(A) Furosemide, a potassium-depleting diuretic, inhibits the reabsorption of sodium and chloride from the loop of Henle and the distal renal tubules. Serum electrolytes are monitored for hypokalemia. (B) Severe acid-base imbalances influence the movement of potassium into and out of the cells, but arterial blood gases to not measure the serum potassium level. (C) Furosemide is a potassium-depleting diuretic. A complete blood count does not reflect potassium levels. (D) Abnormalities in potassium (both hyperkalemia and hypokalemia) are reflected in ECG changes, but these changes do not occur until the abnormality is severe.
NEW QUESTION # 391
A common complication of cirrhosis of the liver is prolonged bleeding. The nurse should be prepared to administer?
- A. Vitamin C
- B. Vitamin A
- C. Vitamin E
- D. Vitamin K
Answer: D
Explanation:
(A) Vitamin C does not directly affect clotting. (B) Vitamin K is a fat-soluble vitamin that depends on liver function for absorption. Vitamin K is essential for clotting. (C) Vitamin E does not directly affect clotting. (D) Vitamin A does not directly affect clotting.
NEW QUESTION # 392
A client who is 7 months pregnant is diagnosed with pyelonephritis. The nurse anticipates the physician ordering:
- A. Oxytocin
- B. Tetracycline
- C. Magnesium sulfate (MgSO )
4 - D. Ampicillin
Answer: D
Explanation:
Section: Questions Set C
Explanation:
(A) Oxytocin is prescribed to stimulate uterine contractions. (B)MgSO4 is a central nervous system depressant prescribed to prevent and control convulsions related to preeclampsia. (C) Ampicillin is a penicillin derivative with no known teratogenic effects. This is the safest antibiotic during pregnancy. (D) Tetracycline stains teeth yellow and is not as safe as ampicillin during pregnancy.
NEW QUESTION # 393
At 32 weeks' gestation, a client is scheduled for a fetal activity test (nonstress test). She calls the clinic and asks the RN, "How do I prepare for the test I am scheduled for?" The RN will most likely inform her of the following instructions to help prepare her for the test:
- A. "You need to know that an IV is always started before the test."
- B. "Do not eat any food or drink any liquids before the test is started."
- C. "You will need to drink 6 to 8 glasses of water to fill your bladder."
- D. "You will have to remain as still as you possibly can."
Answer: D
Explanation:
Explanation/Reference:
Explanation:
(A) An IV line is not started in a nonstress test, because this test is used as an indicator of fetal well-being.
This test measures fetal activity and heart rate acceleration. (B) The bladder does not have to be full prior to this test. It is not a sonogram test where a full bladder enables other structures to be scanned. (C) It has been proved that eating or drinking liquids prior to the test can assist in increasing fetal activity. (D) Any maternal activity will interfere with the results of the test.
NEW QUESTION # 394
The physician orders haloperidol 5 mg IM stat for a client and tells the nurse that the dose can be repeated in
1-2 hours if needed. The most likely rationale for this order is:
- A. Haloperidol is a minor tranquilizer and will not oversedate the client
- B. Rapid neuroleptization is the most effective approach to care for the violent or potentially violent client
- C. The client will settle down more quickly if he thinks the staff is medicating him
- D. The medication will sedate the client until the physician arrives
Answer: B
Explanation:
Section: Questions Set G
Explanation:
(A) If the client could think logically, he would not be paranoid. In fact, he is probably suspicious of the staff, too. Newly admitted clients frequently experience high levels of anxiety, which can contribute to delusions. (B) The goal of pharmacological intervention is to calm the client and assist with reality-based thinking, not to sedate him. (C) Haloperidol is a neuroleptic and antipsychotic drug, not a minor tranquilizer. (D) Haloperidol is a high-potency neuroleptic and first-line choice for rapid neuroleptization, with low potential for sedation.
NEW QUESTION # 395
While the nurse is taking a male client's blood pressure, he makes flirtatious remarks to her. The nurse will handle this effectively if she:
- A. Politely tells the client, "Keep your hands off "
- B. Confronts the remarks but attempts not to reject the client
- C. Ignores the remarks and hopes he will not try it again
- D. Leaves the room in order to compose herself
Answer: B
Explanation:
Explanation
(A) This response does not recognize normal feelings of attraction and rejects the client. (B) By ignoring the situation, the nurse has not set limits to discourage other remarks or perhaps more sexually aggressive behavior. (C) By confronting the remarks, she can recognize that his feelings of attraction may be normal but are not appropriate within the context of their nurse-client relationship. (D) Leaving the room does not deal with setting limits for future interactions.
NEW QUESTION # 396
A 26-year-old client is diagnosed with an astrocytoma, a benign brain tumor. From the nurse's knowledge of the central nervous system, the nurse knows that benign tumors:
- A. Do not warrant concern because they do not become malignant tumors
- B. Can be just as dangerous as malignant tumors
- C. Grow more rapidly than malignant tumors
- D. Can be removed surgically
Answer: B
Explanation:
Explanation/Reference:
Explanation:
(A) Both a benign and a malignant tumor can displace or destroy nearby structures or increase intracranial pressure. (B) Benign or malignant brain tumors grow at different rates depending on the type of tumor. (C) Some benign tumors do become malignant tumors. (D) Whether or not a tumor is operable depends on its location and the amount of damage its removal will cause.
NEW QUESTION # 397
A 4-year-old child has Down syndrome. The community health nurse has coordinated a special preschool program. The nurse's primary goal is to:
- A. Prepare child to enter mainstream education
- B. Provide respite care for the mother
- C. Provide a demanding and challenging educational program
- D. Facilitate optimal development
Answer: D
Explanation:
Explanation/Reference:
Explanation:
(A) Respite care for the family may be needed, but it is not the primary goal of a preschool program. (B) Facilitation of optimal growth and development is essential for every child. (C) A demanding and challenging educational program may predispose the child to failure. Children with retardation should begin with simple and challenging educational programs. (D) Mental retardation associated with Down syndrome may not permit mainstream education. A preschoolprogram's primary goal is not preparation for mainstream education but continuation of optimal development.
NEW QUESTION # 398
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