lOMoARcPSD 40206794 163 Answer B is correct During pregnancy the thyroid gland triples in size This makes it more difficult to regulate thyroid medication Answer A is incorrect because there could be a need for thyroid medication during pregnancy Answer C is incorrect because the thyroid function does not slow Fetal growth is not arrested if thyroid medication is continued so answer D is incorrect 164 Answer C is correct Cyanosis of the feet and hands is acrocyanosis This is a normal finding one minute after birth An apical pulse should be 120 160 and the baby should have muscle tone making answers A and B incorrect Jaundice immediately after birth is pathological jaundice and is abnormal so answer D is incorrect 165 Answer A is correct Clients with sickle cell crises are treated with heat hydration oxygen and pain relief Fluids are increased not decreased Blood transfusions are usually not required and the client can be delivered vaginally thus answers B C and D are incorrect 166 Answer A is correct Before ultrasonography the client should be taught to drink plenty of fluids and not void The client may ambulate an enema is not needed and there is no need to withhold food for eight hours Therefore answers B C and D are incorrect 167 Answer D is correct By one year of age the infant is expected to triple his birth weight Answers A B and C are incorrect because they are too low 242 Chapter 3 168 Answer B is correct A nonstress test is done to evaluate periodic movement of the fetus It is not done to evaluate lung maturity as in answer A An oxytocin challenge test shows the effect of contractions on fetal heart rate and a nonstress test does not measure neurological well being of the fetus so answers C and D are incorrect 169 Answer D is correct Hypospadias is a condition in which there is an opening on the under side of the penis Answers A B and C do not describe hypospadias therefore they are incorrect 170 Answer A is correct Transition is the time during labor when the client loses concentration due to intense contractions Potential for injury related to precipitate delivery has nothing to do with the dilation of the cervix so answer B is incorrect There is no data to indicate that the client has had anesthesia or fluid volume deficit making answers C and D incorrect lOMoARcPSD 40206794 171 Answer C is correct Varicella is chicken pox This herpes virus is treated with antiviral medications The client is not treated with antibiotics or anticoagulants as stated in answers A and D The client might have a fever before the rash appears but when the rash appears the temperature is usually gone so answer B is incorrect 172 Answer B is correct Clients with chest pain can be treated with nitroglycerin a beta blocker such as propranolol or Verapamil There is no indication for an antibiotic such as Ampicillin so answers A C and D are incorrect 173 Answer B is correct Anti inflammatory drugs should be taken with meals to avoid stomach upset Answers A C and D are incorrect Clients with rheumatoid arthritis should exercise but not to the point of pain Alternating hot and cold is not necessary especially because warm moist soaks are more useful in decreasing pain Weightbearing activities such as walking are useful but is not the best answer for the stem 174 Answer D is correct Morphine is contraindicated in clients with gallbladder disease and pancreatitis because morphine causes spasms of the Sphincter of Oddi Meperidine Mylanta and Cimetadine are ordered for pancreatitis making answers A B and C incorrect 175 Answer B is correct Hallucinogenic drugs can cause hallucinations Continuous observation is ordered to prevent the client from harming himself during withdrawal Answers A C and D are incorrect because hallucinogenic drugs don t create both stimulant and depressant effects or produce severe respiratory depression However they do produce psychological dependence rather than physical dependence 176 Answer B is correct Barbiturates create a sedative effect When the client stops taking barbiturates he will experience tachycardia diarrhea and tachypnea Answer A is incorrect even though depression and suicidal ideation go along with barbiturate use it is not the priority Muscle cramps and abdominal pain are vague symptoms that could be associated with other problems Tachycardia is associated with stopping barbiturates but euphoria is not Practice Exam 3 and Rationales 243 lOMoARcPSD 40206794 177 Answer A is correct If the fetal heart tones are heard in the right upper abdomen the infant is in a breech presentation If the infant is positioned in the right occipital anterior presentation the FHTs will be located in the right lower quadrant so answer B is incorrect If the fetus is in the sacral position the FHTs will be located in the center of the abdomen so answer C is incorrect If the FHTs are heard in the left lower abdomen the infant is most likely in the left occipital transverse position making answer D incorrect 178 Answer D is correct Asthma is the presence of bronchiolar spasms This spasm can be brought on by allergies or anxiety Answer A is incorrect because the primary physiological alteration is not inflammation Answer B is incorrect because there is the production of abnormally viscous mucus not a primary alteration Answer C is incorrect because infection is not primary to asthma 179 Answer A is correct The client with mania is seldom sitting long enough to eat and burns many calories for energy Answer B is incorrect because the client should be treated the same as other clients Small meals are not a correct option for this client Allowing her into the kitchen gives her privileges that other clients do not have and should not be allowed so answer D is incorrect 180 Answer B is correct Bryant s traction is used for fractured femurs and dislocated hips The hips should be elevated approximately 15 off the bed Answer A is incorrect because the hips should not be resting on the bed Answer C is incorrect because the hips should not be above the level of the body Answer D is incorrect because the hips and legs should not be flat on the bed 181 Answer B is correct Herpes zoster is shingles Clients with shingles should be placed in contact precautions Wearing gloves during care will prevent transmission of the virus Covering the lesions with a sterile gauze is not necessary antibiotics are not prescribed for herpes zoster and oxygen is not necessary for shingles therefore answers A C and D