The nurse is doing preconception counseling with a 28-year-old woman with no prior pregnancies. Which client statement indicates that teaching has been effective?
1. "A beer once a week will not damage the fetus."
2. "I can continue to drink alcohol until I am diagnosed as being pregnant."
3. "I can drink alcohol while breastfeeding since it does not pass into breast milk."
4. "I need to stop drinking alcohol completely when I start trying to get pregnant."
4
Explanation:
1. It is not known how much alcohol will cause fetal damage; therefore, alcohol during pregnancy is contraindicated.
2. Women should discontinue drinking alcohol when they start to attempt pregnancy.
3. Breastfeeding generally is not contraindicated, although alcohol is excreted in breast milk. Excessive alcohol consumption may intoxicate the infant and inhibit the maternal letdown reflex.
4. Because birth defects that are related to fetal alcohol exposure can occur in the first 3 to 8 weeks' gestation, often before the woman even knows she is pregnant, women should discontinue drinking alcohol when they start to attempt pregnancy.
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The physician has ordered ambulation for the 63-year-old client who has had surgery and has been in bed for three days. The nurse plans to do which of the following for this client?
1. Begin ambulation immediately after breakfast. 2. Pre-ambulation exercises 3. Obtain assistance with transfer of the client. 4. Perform passive ROM before ambulating.
The nurse administers a medication that stimulates the muscarinic receptors. What types of manifestations will the nurse assess in this patient that indicate the drug is working?
A) Pupil dilation B) Increased activity of bowel sounds C) Increased heart rate D) Muscle contractions
The nurse is educating a client who has breast cancer that has metastasized to the bone. Which statement by the client requires additional follow up by the nurse?
A) "My cancer has spread from its primary site." B) "I have two different types of cancer." C) "Like all cancer, mine is the result of damaged DNA or RNA." D) "My cancer may have developed by nature, nurture, or a combination of the two."
What technique does the nurse use when measuring a liquid drug in a medicine cup to ensure an accurate dose?
a. Holding the cup at eye level while pouring the drug b. Holding the cup below eye level while pouring the drug c. Holding the cup above eye level while pouring the drug d. Using a syringe to draw up the drug and then placing it in the medicine cup