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NEW QUESTION 21
A 17-year-old pregnant client who is gravida 1, para 0, is at 36 weeks' gestation. Based on the nurse's knowledge of the maternal physiological changes in pregnancy, which of these findings would be of concern?

• A. Complaints of dyspnea
• B. Pulse of 65 bpm at 8 weeks, 73 bpm at 36 weeks
• C. Hematocrit 39%
• D. Edema of face and hands

Answer: D

Explanation:
Section: Questions Set D
Explanation:
(A) Dyspnea is a common complaint during the third trimester owing to the increasing size of the uterus and the resulting pressure against the diaphragm. (B) Edema of the face, hands, or pitting edema after 12 hours of bed rest may be indicative of preeclampsia and would be of great concern to the healthcare provider. (C) An increase in heart rate of 10-15 bpm is a normal physiological change in pregnancy due to the multiple hemodynamic changes. (D) A hematocrit value of 39% is within the normal range. A value <35% would indicate anemia.

NEW QUESTION 22
A 48-year-old client is in the surgical intensive care unit after having had three-vessel
coronary artery bypass surgery yesterday. She is extubated, awake, alert and talking. She is receiving digitalis for atrial arrhythmias. This morning serum electrolytes were drawn. Which abnormality would require immediate intervention by the nurse after contacting the physician?

• A. Serum potassium is low. The nurse should administer KCl as ordered.
• B. Serum sodium is low. The nurse should change IV fluids to normal saline.
• C. Blood urea nitrogen is subnormal. The nurse should increase the protein in the client's diet as soon as possible.
• D. Serum osmolality is elevated indicating hemoconcentration. The nurse should increase IV fluid rate.

Answer: A

Explanation:
(A)
An elevated serum osmolality poses no immediate danger and is not corrected rapidly.
(B)
A low serum sodium alone does not warrant changing IV fluids to normal saline. Other assessment parameters, such as hydration status, must be considered. (C) A low serum blood urea nitrogen is not necessarily indicative of protein deprivation. It may also be the result of overhydration. (D)A low serum potassium potentiates the effects of digitalis, predisposing the client to dangerous arrhythmias. It must be corrected immediately.

NEW QUESTION 23
The nurse provides a male client with diet teaching so that he can help prevent constipation in the future.
Which food choices indicate that this teaching has been understood?

• A. Cooked oatmeal and grapefruit half
• B. Bagel with cream cheese
• C. Pancakes and syrup
• D. Omelette and hash browns

Answer: A

Explanation:
Explanation
(A) Eggs and hash browns do not provide much fiber and bulk, so they do not effectively prevent constipation.
(B) Pancakes and syrup also have little fiber and bulk, so they do not effectively prevent constipation. (C) Bagel and cream cheese do not provide intestinal bulk. (D) A combination of oatmeal and fresh fruit will provide fiber and intestinal bulk.

NEW QUESTION 24
Respiratory function is altered in a 16-year-old asthmatic. Which of the following is the cause of this alteration?

• A. Paradoxical movements of the chest wall
• B. Continuous changes in respiratory rate and depth
• C. Increased airway resistance
• D. Altered surfactant production

Answer: C

Explanation:
Explanation
(A) Altered surfactant production is found in sudden infant death syndrome. (B) Paradoxical breathing occurs when a negative intrathoracic pressure is transmitted to the abdomen by a weakened, poorly functioning diaphragm. (C) Asthma is characterized by spasm and constriction of the airways resulting in increased resistance to airflow. (D) If the pulmonary tree is obstructed for any reason, inspired air has difficulty overcoming the resistance and getting out. The rate of respiration increases in order to compensate, thus increasing air exchange.

NEW QUESTION 25
The nurse recognizes that a client with the diagnosis of cholecystitis and cholelithiasis would expect to have stools that are:

• A. Bright-red streaked
• B. Black
• C. Clay or gray colored
• D. Watery and loose

Answer: C

Explanation:
(A) Clients who have obstruction in the biliary tract so that bile is not released into the duodenum experience a change in stools from brown to gray or clay colored. (B) This type of stool can occur with other GI problems, such as bacterial or viral infections, and other disease problems, and is not a common finding with biliary obstructions such as cholecystitis and cholelithiasis. (C) This type of stool is usually associated with a GI or bowel problem, such as lower GI bleeding, rather than with biliary obstructions. (D) This type of stool is usually associated with a GI or bowel problem, such as upper GI bleeding, rather than with biliary obstructions.

NEW QUESTION 26
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