The nurse instructs the pregnant woman to report any rupture of the membranes along with a description of the fluid. Which of the following would the nurse evaluate as normal amniotic fluid? (Select all that apply.)
A.
Clear liquid
B.
Contains white specks
C.
Presence of lanugo
D.
Slight ammonia odor
E.
Yellow-greenish color
ANS: A, B, C
Amniotic fluid should be clear and odorless. It may contain white specks and/or fetal hair (lanugo). Yellowish-green tinged fluid may indicate infection or the presence of meconium.
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While working on an orthopedic unit of an acute care facility, the nurse's level of suspicion regarding substance dependency would be heightened if a peer made which of the following comments?
1. "Why don't you go to lunch and I'll give your client something for pain." 2. "I went out with my friends last night and got so drunk on two drinks." 3. "I think Mr. Mathews in room 212 is a drug abuser, because he's always asking for something for pain." 4. "I have a urinary tract infection, and I've had to go to the bathroom every 20 minutes."
A 12-year-old boy is diagnosed with bulimia nervosa. When providing client education to the parents of the client, the nurse points out that what is common in clients afflicted with bulimia nervosa?
A) Inpatient hospital treatment B) Physical ailments related to extreme weight loss C) Substance abuse D) Aggression and violence
The nurse is reviewing the process of hepatic portal circulation with a client. Which information about the hepatic portal circulation is important to include in client teaching?
A) Is a subdivision of pulmonary circulation B) Efficient detour in arterial circulation C) Unique because it begins and ends with capillaries D) Capillaries from the stomach, intestine, spleen, and pancreas empty into arteries
While taking a history, a nurse learns that this client experiences shortness of breath (dyspneic). To determine if the cause of the dyspnea is due to a cardiovascular problem, the nurse would expect which abnormal finding on examination?
a. Flat jugular neck veins b. Red, shiny skin on the legs c. Weak, thready peripheral pulses d. Edema of the feet and ankles