[单项选择]A client is admitted to the labor and delivery unit in active labor. She has had no prenatal care but appears to be between 32 and 35 weeks’ gestation. History reveals that she’s gravida 5, para 1, abortus 3. She tells the nurse she thinks her friend gave her a cigarette containing crack cocaine. What should the nurse do next
A. Move the precipitant delivery cart to the labor room, and notify the neonatologist on call.
B. Teach the mother controlled breathing techniques.
C. Call a family member to come to the hospital.
D. Call the friend who gave the client the cigarette and find out exactly what the drug was.

[单项选择]A client is admitted to the labor and delivery department in preterm labor. To help manage preterm labor the nurse would expect to administer which of the following medication（　）
A. Ritodrine (Yutopar).
B. Bromocriptine (Parlodel).
C. Betamethasone (Celestone).
D. Magnesium sulfate.

[单项选择]A client is being admitted to the labor unit. Because she’s well advanced in labor, the nurse must prioritize the admission questions. Which information is most important to obtain when birth is imminent（）
A. Duration of previous labor.
B. Frequency of contractions.
C. Presence of bloody show.
D. Expected due date.

[单项选择]A client in labor received an epidural anesthetic when her dilation reached 5 cm. Which of the following nursing diagnoses would have the highest priority for her at this time
A. Impaired skin integrity related to inability to move lower extremities.
B. Impaired urinary elimination related to the effects of the epidural.
C. Deficient knowledge related to lack of information about regional anesthesia.
D. Risk for injury related to hypotension secondary to vasodilation and pooling in extremities.

[单项选择]A client with hypotonic labor dysfunction is receiving oxytoein augmentation. Her contractions become more frequent and intense. Dilation progresses to 8 cm, but the fetal head remains at station +1. The nurse notes a soft bulge just above the symphysis. Which of the following actions is best（）
A. Re-evaluate the fetal presentation.
B. Change the client’s position.
C. Offer a narcotic analgesic.
D. Help the client urinate.

[单项选择]A psychiatric client who was voluntarily admitted now wishes to be discharged from the hospital, against medical advice. What’s the most important assessment the nurse should make of the client
A. Ability to care for himself.
B. Degree of danger to self and others.
C. Level of psychosis.
D. Intended compliance with aftercare.

[单项选择]Assessment of a client in active labor reveals meconium-stained amniotic fluid and fetal heart sounds in the upper right quadrant. Which of the following is the most likely cause of this situation（　）
A. Breech position.
B. Late decelerations.
C. Entrance into the second stage of labor.
D. Multiple gestation.

[单项选择]A client admitted for a hysterectomy has a secondary diagnosis of Ménière s disease. Which of the following nursing interventions should the nurse include in the client’s plan of care to decrease the effects of tinnitus（）
A. Reduce the amount of glucose and cholesterol in the diet.
B. Encourage the client to listen to the radio with earphones.
C. Encourage a weight-reduction diet.
D. Administer antihypertensive medications as ordered.

[单项选择]The nurse is interviewing a client admitted to the facility with a diagnosis of schizophrenia. The client states, "I run apple, train, grass, window. " This response by the client is known as（）
A. echopraxia.
B. a word salad.
C. flight of ideas.
D. neologisms.

[单项选择]A client is admitted for a suspected eating disorder. Which of the following statements would indicate that the client may be suffering from anorexia nervosa（）
A. "I’ve gained 3 pounds in the last month. "
B. "I eat loads of spinach and yellow vegetables each day. "
C. "I’m a perfectionist, and I work hard to get A’s. "
D. "I binge frequently in the morning and feel fat. "

[单项选择]An elderly client is admitted to the hospital with the diagnoses of dementia of the Alzheimer’s type and depression. The client has all of the following symptoms. The symptom that is unrelated to the depression would be（　）
A. Shallow or labile affect
B. Neglect of personal hygiene
C. "I don’t know" answers to questions
D. Apathetic response to the environment

[单项选择]A client is admitted with a diagnosis of delusions of grandeur. This diagnosis reflects the client has a belief that he is（）
A. highly important or famous.
B. being persecuted.
C. connected to events unrelated to himself.
D. responsible for the evil in the world.

[单项选择]A client is admitted to the psychiatric unit with a diagnosis of anorexia nervosa. Although she is 5’7" and weighs only 100 lb, she keeps on telling the nurse about how fat she is. What should the nurse do first（）
A. Discuss cultural stereotypes regarding thinness and attractiveness.
B. Explore the reasons why the client doesn’t eat.
C. Teach the client about nutrition, calories, and a balanced diet.
D. Establish a trusting relationship with the client.

[单项选择]A client is admitted with atrial fibrillation. The physician noted a pulse deficit. The pulse deficit measures which of the following（）
A. The difference between apical and radial pulse rates.
B. The difference between systolic and diastolic blood pressures.
C. The amount of blood ejected from the left ventricle per minute.
D. The percentage of blood emptied from the ventricle during contraction.

[单项选择]A client is admitted with a suspected diagnosis of an acute myocardial infarction. When providing care for the client, the nurse should avoid which route when taking a temperature（）
A. Oral.
B. Rectal.
C. Axillary.
D. Tympanic.

[单项选择]A client is admitted to the hospital for treatment of Prinzmetal’s angina. When developing the client’s plan of care, the nurse should remember that this type of angina is triggered by（）
A. coronary artery spasm.
B. an unpredictable amount of activity.
C. activities that increase oxygen demand.
D. an unknown source.

[单项选择]A client is admitted to the emergency department with complaints of chest pain and shortness of breath. The nurse’s assessment reveals jugular vein distention. The nurse knows that when a client has jugular vein distention, it’s typically due to（）
A. a neck tumor.
B. an electrolyte imbalance.
C. dehydration.
D. fluid overload.

[单项选择]A client is admitted for an overdose of amphetamines. When assessing this client, the nurse should expect to have which of the following findings（）
A. Tension and irritability.
B. Slow pulse.
C. Hypotension.
D. Constipation.

[单项选择]An elderly female client is admitted to a nursing home from the general hospital with a diagnosis of dementia of the Alzheimer’s type. One morning, after being in the nursing home for several days, the client is going to join a group of residents in recreational therapy. The nurse notes that the client has laid out several dresses on her bed but has not changed from her nightclothes. It would be most helpful for the nurse to（　）
A. Remind the client to dress more quickly to avoid delaying the other residents
B. Help the client select appropriate attire and offer her assistance in getting dressed
C. Help the client dress and tell her what time the residents are expected at the activity
D. Allow the client as much time as she needs but explain that she is too late to attend this activity