A client at 21 weeks’ gestation recently

A client at 21 weeks’ gestation recently diagnosed with hyperemesis gravidarum asks the nurse, “Why is this happening to me? I don’t know whether I can go on like this.” Which response by the nurse is appropriate? 1 “Are you saying that you want to schedule an abortion?” 2 “This must be physically and emotionally challenging for you.” 3 “We’re doing the best we can here, so please be patient with us.” 4 “Dietary changes and medications are available that can ease the nausea.” 2. A client in her 36th week of gestation is admitted with vaginal bleeding, severe abdominal pain, a rigid fundus, and signs of impending shock. For which intervention would the nurse prepare? 1 A high-forceps birth 2 An immediate cesarean birth 3 Insertion of an internal fetal monitor 4 Administration of an oxytocin infusion 3. Which is an appropriate response to a client with placenta previa who is concerned that she had done something to cause the onset of vaginal bleeding? 1 “It’s not your fault; these things happen.” 2 “Don’t worry; it’s just a sign that labor is beginning.” 3 “Your uterus may be weak—that’s what causes the vaginal bleeding.” 4 “You have a low-lying placenta that separates when the cervix dilates.” 4. While assessing a client during the fourth stage of labor, the nurse notes that the perineal pad is soaked with approximately 75 mL of lochia rubra. Which nursing action is the priority? 1 Massage the uterine fundus. 2 Document the amount and type of lochia. 3 Accompany the client to the bathroom to empty her bladder. 4 Draw blood to test for hemoglobin and hematocrit levels. 5. Which iron-rich foods would the nurse encourage the client with mild anemia in early pregnancy to eat? Select all that apply. One, some, or all responses may be correct. 1 Dark leafy green vegetables 2 Legumes 3 Dried fruits 4 Yogurt 5 Ground beef patty 6. Which comfort intervention would the nurse recommend to a client’s coach when the client reports low back pain? 1 Instruct her to flex her knees. 2 Place her in the supine position. 3 Apply pressure to her back during contractions. 4 Perform neuromuscular control exercises with her. 7. The dosage of an intravenous infusion of magnesium sulfate prescribed for a client with severe preeclampsia is twice the usual adult dosage. When the nurse questions the dosage, the primary health care provider insists that it is the desired dosage and directs the nurse to administer the medication. Which action would the nurse take in response to this directive? 1 Administer the dose and monitor the client. 2 Withhold the dose and notify the nurse manager. 3 Administer half the dose, and document it on the client’s record. 4 Withhold the dose and notify the director of the obstetrics department. 8. A client in preterm labor at 34 weeks’ gestation is receiving intravenous tocolytic therapy. The infusion is discontinued when the frequency of her contractions increases to every 10 minutes, and her cervix dilates to 4 cm. Which is the priority goal of nursing care at this time? 1 Reduction of anxiety associated with preterm labor 2 Promotion of maternal and fetal well-being during labor 3 Supportive communication with the client and her partner 4 Helping the family cope with the impending preterm birth 9. The nurse in a prenatal clinic is assessing a woman at 34 weeks’ gestation. The client’s blood pressure is 166/100 mm Hg and her urine is +3 for protein. She states that she has a severe headache and occasional blurred vision. Her baseline blood pressure was 100/62 mm Hg. Which action would the nurse take in response to these findings? 1 Arrange transportation to the hospital. 2 Obtain a prescription for an antihypertensive. 3 Recheck the blood pressure within 30 minutes. 4 Obtain a prescription for acetaminophen to relieve the headache. 10. A client being prepared for surgery because of a ruptured tubal pregnancy reports that she feels light-headed. Her pulse is rapid, and her color is pale. Which common complication of a ruptured tubal pregnancy is suggested by these findings? 1 Shock 2 Anxiety 3 Infection 4 Hyperoxygenation 11. Reluctance of a client who is one day postpartum to engage in which activity raises a concern about mother-infant bonding? 1 Undress the newborn 2 Breast-feed her newborn 3 Look at her newborn’s face 4 Attend classes for newborn care 12. The nurse is caring for a client whose fetus is in a breech presentation. The membranes rupture and meconium appears in the vaginal introitus. Which would the nurse recognize this indicates? 1 A potential for cord prolapse 2 Evidence of fetal heart abnormalities 3 A common occurrence in breech presentations 4 A condition requiring immediate notification of the primary health care provider 13. Which postpartum complication would the nurse monitor for in a client with hydramnios? 1 Infection 2 Hemorrhage 3 Hypertension 4 Thromboembolism 14. Which client would the nurse identify as being at the greatest risk for a hypertensive disorder of pregnancy? 1 Obese primigravida 2 31-year-old multipara 3 Multipara with more than six previous pregnancies 4 Primigravida who took oral contraceptives within 3 months of conception 15. Which action would the nurse initiate first to ensure the physical safety of a client with severe preeclampsia? 1 Institute seizure precautions. 2 Decrease environmental stimuli. 3 Administer the prescribed sedatives. 4 Strictly monitor her intake and output. 16. Which assessment findings correlate with a diagnosis of unruptured tubal pregnancy? Select all that apply. One, some, or all responses may be correct. 1 Rigid abdomen 2 Referred shoulder pain 3 Unilateral abdominal pain 4 History of a sexually transmitted infection (STI) 5 Ecchymotic blueness around the umbilicus 17. Which is the priority nursing care focus for a client at 34 weeks’ gestation with contractions every 5 minutes and cervical dilation of 4 cm? 1 Promoting maternal/fetal well-being during labor 2 Reducing the anxiety associated with preterm labor 3 Supporting communication between the client and her partner 4 Assisting the client and her partner with the breathing techniques needed as labor progresses 18. Which assessment finding after spontaneous rupture of the membranes in a client with a fetus in the left occiput posterior position needs to be reported to the primary health care provider? 1 Greenish amniotic fluid 2 Shortened intervals between contractions 3 Clear amniotic fluid with specks of mucus 4 Maternal temperature of 99.1°F (37.3°C) 19. A multiparous client with a history of gestational hypertension and previous history of abruption is in the transition phase of labor. The electronic fetal monitor shows bradycardia, and a change is seen in the contour of the client’s abdomen. Which is the nurse’s immediate action? 1 Checking the client’s vital signs 2 Placing the client on her left side 3 Applying an internal scalp electrode on the fetus 4 Alerting staff to the need for immediate cesarean delivery 20. When planning care for a client with type 1 diabetes, which change in insulin requirements would the nurse anticipate on the first postpartum day? 1 Slow decrease 2 Rapid increase 3 Sudden decrease 4 Gradual increase 21. Which safety measure would the nurse include when administering methotrexate? 1 Dispose of gloves used to administer methotrexate in a garbage bag. 2 Obtain the client’s weight for calculation of the dose of methotrexate. 3 Wear two pair of gloves before removing the syringes from the plastic bag. 4 Expel additional air from the syringe of methotrexate and prime the needle. 22. Which statement contains information that would be included when answering a client’s questions about episiotomy versus laceration? 1 Lacerations are more painful than an episiotomy. 2 Lacerations are easier to repair than an episiotomy. 3 An episiotomy causes less posterior trauma than lacerations. 4 An episiotomy is preferred over lacerations, according to evidence-based practice. 23. Which information would the nurse include when teaching a client experiencing a postterm pregnancy? Select all that apply. One, some, or all responses may be correct. 1 Monitor for signs of labor. 2 Perform daily fetal movement counts. 3 Go to the birthing facility soon after labor begins. 4 Call the primary health care provider if the membranes rupture. 5 Keep appointments for fetal assessment tests and cervical checks. 24. The nurse is assessing a postpartum client for signs of hemorrhage by evaluating the degree of perineal pad saturation. Which other parameter can the nurse use to estimate blood loss in a postpartum client? 1 Odor of the lochia 2 Color of the lochia 3 Presence of small clots on the pad 4 Time elapsed between pad changes 25. Which risk to the fetus is associated with a maternal diagnosis of chorioamnionitis? Select all that apply. One, some, or all responses may be correct. 1 Sepsis 2 Bacteremia 3 Pneumonia 4 Cerebral palsy (CP) 5 Respiratory distress syndrome (RDS) 1. Which strategies would the nurse teach a client who says, “I have been having trouble sleeping and feel wide awake as soon as I get into bed”? Select all that apply. One, some, or all responses may be correct. 1 Eating a heavy snack near bedtime 2 Reading in bed before shutting out the light 3 Leaving the bedroom when unable to sleep 4 Drinking a cup of warm coffee with milk at bedtime 5 Exercising in the afternoon rather than in the evening 6 Drinking at least 1 glass of wine or other alcoholic beverage at bedtime 2. Which action would the nurse take for a client who paces back and forth across the floor, speaks incoherently, and continually talks to and verbally fights with people who are not present? 1 Set limits on the client’s verbal aggression. 2 Isolate the client to decrease the aggressive behavior. 3 Establish a relationship to reduce the client’s loneliness. 4 Provide emotional support while demonstrating acceptance of the client. 3. Which guideline would the nurse consider when planning care for a hospitalized older client with Alzheimer disease? 1 Physical contact will increase dependency needs. 2 Routines provide stability for clients with neurocognitive disorders. 3 Regressive behavior should be interrupted immediately. 4 Procedures do not have to be explained to clients with neurocognitive disorders. 4. Which undertaking would the nurse suggest for an emotionally disturbed client who is ready to begin participating in therapeutic social activities? 1 Drawing pictures with the nurse 2 Attending a class on medications 3 Participating on the softball team 4 Watching television in the dayroom 6. In an effort to foster a healthy grief response to the birth of a stillborn child, which response would the nurse make to the mother’s questions about the cause? 1 “This often happens when something is wrong with the baby.” 2 “It’s God’s will; we have to have faith that it was for the best.” 3 “You’re young, and you’ll have other children—wait and see.” 4 “You may be wondering whether something you did caused this.” 7. Which response would the nurse make to a client who says, “Please let me go. I trust you. The Mafia is going to kill me tonight”? 1 “You’re frightened. Come with me to your room, and we can talk about it.” 2 “Come with me to your room. I’ll lock the door and no one will get in to harm you.” 3 “Nobody here wants to harm you, and you know that. I’ll come with you to your room.” 4 “Thank you for trusting me. Maybe you can trust me when I tell you that no one will kill you here.” 8. Which rationale describes the reason the nurse would ask a client who has been raped to describe what happened? 1 This information will help the nursing staff give legal advice and provide counseling. 2 Talking about the assault will help the client see how actions may have led to the event. 3 It will let the client put the event in better perspective and help begin the resolution process. 4 Discussing the details will keep the client from concealing the intimate happenings during the assault. 9. Which would the nurse ask to obtain information about a bulimic client’s intake habits and patterns? 1 “Are you trying to control other people through the use of food?” 2 “When you socialize, do you find that you eat more than when you eat by yourself?” 3 “Do you find yourself eating more right before the beginning of your menstrual cycle?” 4 “How often are you eating in response to your feelings rather than because you’re hungry?” 10. Which response would the nurse make to a depressed client who says, “I’m stupid and useless. Talk with the other people who are more important”? 1 “Everyone is important.” 2 “Do you feel that you’re not important?” 3 “Why do you feel that you’re not important?” 4 “I want to talk with you because you are important to me.” 11. Which approach would the nurse use for a client with an obsessive-compulsive disorder to decrease the use of ritualistic behavior? 1 Providing repetitive activities that require little thought 2 Attempting to limit situations that will worsen the anxiety 3 Getting the client involved in activities that will provide distraction 4 Suggesting that the client perform menial tasks to hide feelings of guilt 12. Place these interventions in priority order, from the least to the most restrictive, when dealing with a bipolar manic client who is threatening staff and clients. 1. Seclusion 2. Restraints 3. Limit-setting 4. Diversional activities 5. Medication administration 13. Which priority concern would the nurse monitor for while working with clients withdrawing from cocaine? 1 Risk for self-injury 2 Potential for seizure 3 Danger of dehydration 4 Probability of injuring others 14. Which response would the nurse anticipate for a client who comes to the mental health clinic for treatment of a phobia of large dogs? 1 Fear while discussing the phobia 2 Resentment toward the feared object 3 Inadequate impulse control when threatened 4 Distortion of reality when discussing the phobia 15. Which side effect would the nurse monitor for when administering a selective serotonin reuptake inhibitor (SSRI)? Select all that apply. One, some, or all responses may be correct. 1 Anxiety 2 Nausea 3 Sedation 4 Restlessness 5 Suicidal ideation 6 Increased energy level 16. Which short-term outcome would the nurse add to the plan of care for a client with schizophrenia who is in a catatonic, vegetative state? 1 Talking with peers 2 Performing activities of daily living 3 Completing unit activities and assignments 4 Ingesting adequate fluid and food with assistance 17. Which response would the nurse make to a client who has just experienced a panic attack? 1 “I would have been upset, too.” 2 “You are concerned that this might happen again.” 3 “Episodes like this will always come to an end.” 4 “Your family must have thought that you were having a heart attack.” 18. Which therapeutic approach would indicate the client is receiving desensitization therapy? 1 Imagery 2 Modeling 3 Role playing 4 Assertiveness training 19. Which response would the nurse make to a disturbed client who says, “The voices are saying that I killed my husband”? 1 “I just saw your husband, and he’s doing fine.” 2 “Tell me more about your concerns for your husband.” 3 “We’ll put you in a private room where you’ll be safe.” 4 “You seem to be having very frightening thoughts right now.” 20. Which response would the nurse make to a client with obsessive-compulsive disorder who says, “I know that my hands aren’t dirty, but I just can’t stop washing them”? 1 “Let’s talk about why you feel that you have to wash your hands.” 2 “You’re getting better; you’re beginning to understand your problem.” 3 “Don’t worry about it; these actions are part of your illness, and the feelings will pass.” 4 “I understand that—maybe we can work together to limit the number of times you wash them.” 21. Which signs and symptoms would the nurse observe in a client with bipolar disorder, depressed episode? 1 Elated affect related to reaction formation 2 Loose associations related to a thought disorder 3 Physical exhaustion related to decreased physical activity 4 Paucity of verbal expression related to slowed thought processes 22. To further assess a client’s suicidal potential, the nurse would be especially alert to the client’s expression of which emotions? 1 Anger and resentment 2 Loneliness and anxiety 3 Frustration and fear of death 4 Helplessness and hopelessness 23. Which precipitating factors for depression would be common in the older adult without neurocognitive problems? Select all that apply. One, some, or all responses may be correct. 1 Dementia 2 Multiple losses 3 Declines in health 4 A milestone birthday 5 A traumatic injury 24. A client reports being physically abused by his or her partner. Which interventions would the nurse include in the plan of care? Select all that apply. One, some, or all responses may be correct. 1 Press for information. 2 Assess level of danger. 3 Use medical terminology. 4 Have others in the interview. 5 Notify adult protective services. 25. An anxious, panicked client states, “I admitted myself because I think I’m going crazy.” Which interpretation would the nurse make about the client’s remark? 1 This is a plea for support. 2 The client has insight. 3 This is a symptom of depression. 4 The client is testing the nurse’s trust. SCIENCE HEALTH SCIENCE NURSING NUR 3290

******CLICK ORDER NOW BELOW AND OUR WRITERS WILL WRITE AN ANSWER TO THIS ASSIGNMENT OR ANY OTHER ASSIGNMENT, DISCUSSION, ESSAY, HOMEWORK OR QUESTION YOU MAY HAVE. OUR PAPERS ARE PLAGIARISM FREE*******."