LIPPINCOTT'S REVIEW FOR NCLEX-RN

A 16-years old unmarried client visits the prenatal clinic at 32 weeks gestation. The client is 5 feet, 2 inches tall and weighed 120 pounds before the pregnancy, the client now weighs 140 pounds. She has been receiving care at the clinic and is being carefully monitored for early signs of pregnancy-induced hypertension (PIH) 1. The nurse assess the client for possible risk factors for PIH, which of the following will be most important for the nurse to assess ? a.Proteinuria b.Small for gestation age fetus c.ABO incompability d.Fluid intact. (the correct answer is a, The most important assessment is checking the urine for protein. Proteinuria, even in the absence of an elevated blood pressure, is indicative of PIH. PIH occurs more often in primigravidas , adolescents, woman of lower socioeconomic status, primigravidas older then 35 years, woman with family histories of PIH and woman with additional complication such as multiple gestation, diabetic mellitus, Rh incompatibili

The Client arrive late for an appointment with the nurse in out patient clinic. During in interview,he fidgets restlessly,has trouble remembering what topic is being discussed, and says he thinks he is going crazy. 1.Which of the following statement by the nurse would best deal with the client's feeling about 'going crazy' a.'I see that this concerns you,but what does 'crazy' mean to you?' b.'Most people feel that way occasionally,you are no different from any one else' c.'I don't know enough about you to judge,why don't you tell me more about yourself' d.'You sound perfectly sane to me,may be your perception of word Crazy is different from mine' (the correct answer is a, when the client says he thinks he is 'Going Crazy' it is best for the nurse to ask him what 'Crazy' means ti him, before moving toward consensual validation, the nurse must have a clear idea of what the client  means by his words

THE CLIENT WITH AN ANXIETY DISORDER  A client brought to hospital emergency room by his brother. The client is perspiring profusely,breathing rapidly and complaining of dizziness and palpitations. Problem of a cardiovascular nature are ruled out. The client's diagnosis is tentatively listed as panic attack.  1 The emergency room nurse observe that the client is hyperventilating, which of the following measures would be best to try first to ease the symptoms caused by hyperventilation.  a.Have the client breath in to the paper bag.  b.Instruct the client to put his head between his knee. c.Give the client a low concentration of oxygen by nasal Cannula. d.Tell the client to take several deep,slow breaths and exhale normally.  (The correct answer is a,The best way to easy symptoms caused by hyperventilation is to have the client breath into a paper bag. Having the client put his head between knees,giving him low concentration oxygen and having him take deep breath, slow

A Client is admitted to the psychiatric unit accompanied by her husband. She brings six suitcases and three shopping bags. She orders the nurse to carry her bags. Her husband states she has been purchasing items that hey can not afford and has not slept for 4 nights 1. Which additional information would be priority for the nurse to seek from the client's husband?;    a. The client's fluid and food intake.    b. Their current financial status.    c. The client's usual sleeping pattern.    d. Whether the client becomes agitated easily.   (The correct answer is a, Assessing nutritional status is a priority in this situation. A client with bipolar disorder,maniac phase commonly does not have time to eat or drink because of their state of constant activity and easy destructibility. Altered nutritional status and constant physical activity can lead to malnutrition,weight loss and physical exhaustion.These state can lead to death appropriate attention is not institute

A 62-years-old client comes to the neighborhood health center for his annual physical examination. 1. While interacting with the nurse,the client states that he feels tired all of the time, has trouble sleeping and has problem in thinking. The best nursing action is to;      a.Inform the client about the normal aging process.    b.Further assess the client's mental status and mental history.    c.Refer the client to a senior citizen'support group.    d.Advice the client to discontinue day time napping. (The correct answer is b, The client is exhibiting signs of possible depression. The nurse should explore his medical history and conduct a mental status examination to further assess and explore his possibility. He is not exhibiting sign and symptoms of the normal aging process. Referral to a senior citizen'support group may be will appropriate later,depending on the client's need and interest. Day time napping should be discouraged if it interrupt  night t