Nursing practice questions with comprehensive rationales
NurseDive Free Nursing Practice Question
A nurse is providing teaching to a client who has fibrocystic breast changes and is experiencing breast discomfort during menstruation. Which of the following instructions should the nurse include?
A. "Increase potassium intake.”
Increasing potassium intake is not specifically associated with relieving breast discomfort during menstruation. There is no established link between potassium intake and fibrocystic breast changes.
B. "Increase fluid intake to 3 liters per day.”
Increasing fluid intake is generally beneficial for overall health, but it is not a specific recommendation for managing breast discomfort during menstruation. It may not have a direct impact on fibrocystic breast changes.
C. "Decrease sodium intake before menstruation.”
Decreasing sodium intake before menstruation is a relevant instruction for managing breast discomfort associated with fibrocystic breast changes. High sodium intake can lead to water retention and breast swelling, exacerbating discomfort.
D. "Decrease daily fiber intake.”
Daily fiber intake is important for bowel health but is not directly related to managing breast discomfort during menstruation or fibrocystic breast changes.
This question is an excerpt from Nurse Dive's nursing test bank - ATI Maternal Newborn Proctored Exam. Take the full exam now
Full Explanation
Choice A rationale:
Increasing potassium intake is not specifically associated with relieving breast discomfort during menstruation. There is no established link between potassium intake and fibrocystic breast changes.
Choice B rationale:
Increasing fluid intake is generally beneficial for overall health, but it is not a specific recommendation for managing breast discomfort during menstruation. It may not have a direct impact on fibrocystic breast changes.
Choice C rationale:
Decreasing sodium intake before menstruation is a relevant instruction for managing breast discomfort associated with fibrocystic breast changes. High sodium intake can lead to water retention and breast swelling, exacerbating discomfort.
Choice D rationale:
Daily fiber intake is important for bowel health but is not directly related to managing breast discomfort during menstruation or fibrocystic breast changes.
Similar Questions
A nurse is caring for a client who is postpartum, has a deep-vein thrombosis, and is receiving heparin therapy via subcutaneous injections. Which of the following actions should the nurse take?
A. Request a prescription for PRN aspirin from the provider.
Requesting a prescription for PRN aspirin is incorrect because aspirin is an antiplatelet agent and should not be combined with heparin without specific medical advice due to the increased risk of bleeding.
B. Massage the injection site thoroughly following administration.
Massaging the injection site is not recommended as it can cause trauma to the tissue and increase the risk of bleeding, which is especially concerning in a patient with deep-vein thrombosis.
C. Instruct the client that they cannot breastfeed while receiving heparin.
Instructing the client that they cannot breastfeed while receiving heparin is incorrect. Heparin does not pass into breast milk in significant amounts and is considered safe for use while breastfeeding.
D. Administer the injection in the client's abdomen.
Heparin is typically administered subcutaneously in the abdomen because it is an area with large amounts of subcutaneous fat, to ensure proper absorption and minimize discomfort.
Full Explanation
Choice A reason:
Requesting a prescription for PRN aspirin is incorrect because aspirin is an antiplatelet agent and should not be combined with heparin without specific medical advice due to the increased risk of bleeding.
Choice B reason:
Massaging the injection site is not recommended as it can cause trauma to the tissue and increase the risk of bleeding, which is especially concerning in a patient with deep-vein thrombosis.
Choice C reason:
Instructing the client that they cannot breastfeed while receiving heparin is incorrect. Heparin does not pass into breast milk in significant amounts and is considered safe for use while breastfeeding.
Choice D reason:
Administer the injection in the client's abdomen. Heparin is typically administered subcutaneously in the abdomen to ensure proper absorption and minimize discomfort. Because it is an area with large amounts of subcutaneous fat
A nurse is caring for a client who is in labor and has an epidural for pain control. Which of the following clinical manifestations is an adverse effect of epidural anesthesia?
A. Polyuria.
Polyuria is not an adverse effect of epidural anesthesia. It is unrelated to this type of pain control.
B. Hypertension.
Hypertension is not an adverse effect of epidural anesthesia. Epidurals can actually cause a decrease in blood pressure due to vasodilation.
C. Pruritus.
This is the correct choice. Pruritus, or itching, is a common adverse effect of epidural anesthesia caused by the release of histamines from local anesthetics.
D. Dry mouth.
Dry mouth is not an adverse effect of epidural anesthesia. Dry mouth is more commonly associated with general anesthesia or medications with anticholinergic effects.
Full Explanation
Choice A rationale:
Polyuria is not an adverse effect of epidural anesthesia. It is unrelated to this type of pain control.
Choice B rationale:
Hypertension is not an adverse effect of epidural anesthesia. Epidurals can actually cause a decrease in blood pressure due to vasodilation.
Choice C rationale:
This is the correct choice. Pruritus, or itching, is a common adverse effect of epidural anesthesia caused by the release of histamines from local anesthetics.
Choice D rationale:
Dry mouth is not an adverse effect of epidural anesthesia. Dry mouth is more commonly associated with general anesthesia or medications with anticholinergic effects.
A nurse is caring for a newborn whose father voices concerns about his ability to bond with his baby. Which of the following actions should the nurse take to facilitate bonding? (Select all that apply.)
A. Point out to the father that the newborn turns toward his voice.
Pointing out to the father that the newborn turns toward his voice helps him understand that the baby is already responding to him, promoting bonding.
B. Ask the father why he is concerned about bonding with the newborn.
Asking the father why he is concerned about bonding with the newborn allows the nurse to address specific fears or misconceptions and provide appropriate support.
C. Encourage the father to touch and stroke the newborn's skin.
Encouraging the father to touch and stroke the newborn's skin promotes physical contact and enhances the bonding process.
D. Demonstrate diapering and swaddling techniques for the father.
Demonstrating diapering and swaddling techniques for the father helps him feel more confident in caring for his baby and fosters bonding through caregiving activities.
E. Encourage the father to lay the newborn beside him while both are sleeping.
Encouraging the father to lay the newborn beside him while both are sleeping promotes skin- to-skin contact and allows for bonding during restful moments. However, the nurse should ensure that safety measures are followed to prevent accidental suffocation. By following these actions, the nurse can support the father's bonding with his newborn and facilitate a positive and nurturing parent-infant relationship.
Full Explanation
Choice A rationale:
Pointing out to the father that the newborn turns toward his voice helps him understand that the baby is already responding to him, promoting bonding.
Choice B rationale:
Asking the father why he is concerned about bonding with the newborn allows the nurse to address specific fears or misconceptions and provide appropriate support.
Choice C rationale:
Encouraging the father to touch and stroke the newborn's skin promotes physical contact and enhances the bonding process.
Choice D rationale:
Demonstrating diapering and swaddling techniques for the father helps him feel more confident in caring for his baby and fosters bonding through caregiving activities.
Choice E rationale:
Encouraging the father to lay the newborn beside him while both are sleeping promotes skin- to-skin contact and allows for bonding during restful moments. However, the nurse should ensure that safety measures are followed to prevent accidental suffocation. By following these actions, the nurse can support the father's bonding with his newborn and facilitate a positive and nurturing parent-infant relationship.