A woman who is 16 weeks pregnant with her first child is concerned because she has not felt the fetus move. What is the most appropriate explanation for a nurse to give this patient?
a. Movement of a fetus in the first pregnancy often does not occur until the twenty-fourth week of pregnancy.
b. A referral to an obstetrician should be made for further evaluation of this finding.
c. Movement of the fetus is not expected until the nineteenth week of pregnancy.
d. Movement of the fetus is related to fundal height; the greater the fundal height, the sooner the fetal movement.
ANS: C
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A nursing student is caring for a client with leukemia. The student asks why the client is still at risk for infection when the client's white blood cell count (WBC) is high. What response by the registered nurse is best?
a. "If the WBCs are high, there already is an infection present." b. "The client is in a blast crisis and has too many WBCs." c. "There must be a mistake; the WBCs should be very low." d. "Those WBCs are abnormal and don't provide protection."
The nurse interprets which of the following statements as an indication that the elderly client is meeting the developmental task for this stage of life?
1. "If I could live my life over, I would do a lot of things differently." 2. "It's been lonely, but I have found a new sweetheart in the nursing home." 3. "I didn't do everything I wanted to in life, but I am happy with what I accomplished." 4. "My kids didn't want my belongings, so I willed them to charity."
The nurse is assessing an adult patient's heart sounds. In which order should the nurse hear the sounds?
1. S1, then S2 2. S2, then S3 3. S3, then S4 4. S2, then S1
Calculate the milliliters per hour of heparin required for the continuous infusion. Order: Begin a heparin drip per the facility's protocol. The patient's weight is 96 kg
Heparin Protocol Bolus: Heparin 80 units/kg Infusion: Heparin 18 units/kg/h using a concentration of heparin 25,000 units in 250 mL of NS (100 units/mL)