The nurse is caring for a client in labor. The nurse determines that the client is beginning the second stage of labor when which of the following is documented in the client's record?
1. The contractions are regular.
2. The membranes have ruptured.
3. The cervix is completely dilated.
4. The client begins to expel clear vaginal fluid.
3
Rationale: The second stage of labor begins when the cervix is completely dilated and ends with birth of the infant. The other options are not specific assessment findings of the second stage of labor.
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A nurse is teaching a group of students about the stigma that is often associated with mental illness. The nurse tells the group that stigma associated with mental illness is about which of the following?
1. Disrespect 2. Intelligence 3. Respect 4. Appreciation
Where is the major portion of fat digested?
a. Mouth b. Stomach c. Small intestine d. Large intestine
Nursing care for a client with urinary bladder calculi should include
a. checking for abdominal distention. b. collecting a 24-hour urine specimen for calcium. c. encouraging fluid intake up to 4000 ml/day. d. maintaining bed rest.
What type of nursing position would most likely provide experience in the type of nursing situations upon which the NCLEX® Exam questions are based?
a. Home care nurse b. Psychiatric staff nurse c. Staff nurse in an ambulatory pediatric clinic d. Staff nurse in a medical-surgical inpatient unit