A female client has married recently. A month ago she visited her physician with complaints of burning on urination. She was given a prescription for trimethoprim- sulfamethoxazole (Bactrim) DS bid for 10 days.
She was admitted through the emergency room on Saturday evening complaining of flank pain. Her temperature was 104_F. A preliminary urinalysis revealed 31 bacteria along with red and white blood cells in the urine. A preliminary diagnosis of pyelonephritis was made. During a nursing admission assessment, which statement by the client demonstrates a possible cause for pyelonephritis?

• A."I have not been drinking six to eight glasses of water each day as the nurse had instructed."
• B."I'm afraid I may have something wrong with my bladder because I have been getting bladder infections frequently since I've been married."
• C."I took the Bactrim for 6 or 7 days. The burning stopped, so I saved the rest of the medication for the next time."
• D."I recently had the flu, which could be settling in my kidneys now."

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A 27-year-old primigravida at 32 weeks' gestation has been diagnosed with complete placenta previa. Conservative management including bed rest is the proper medical management. The goal for fetal survival is based on fetal lung maturity. The test used to determine fetal lung maturity is:

• A.Dinitrophenylhydrazine
• B.Metachromatic stain
• C.Blood serum phenylalanine test
• D.Lecithin-sphingomyelin ratio

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Which of the following menu choices would indicate that a client with pressure ulcers understands the role diet plays in restoring her albumin levels?

• A.Broiled fish with rice
• B.Bran flakes with fresh peaches
• C.Lasagna with garlic bread
• D.Cauliflower and lettuce salad

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A mother frantically calls the emergency room (ER) asking what to do about her 3-year-old girl who was found eating pills out of a bottle in the medicine cabinet. The ER nurse tells the mother to:

• A.Give the child 15 mL of syrup of ipecac.
• B.Give the child 10 mL of syrup of ipecac with a sip of water.
• C.Give the child 1 cup of water to induce vomiting.
• D.Bring the child to the ER immediately.

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A client is receiving IV morphine 2 days after colorectal surgery. Which of the following observations indicate that he may be becoming drug dependent?

• A.The client requests pain medicine every 4 hours.
• B.He is asleep 30 minutes after receiving the IV morphine.
• C.He asks for pain medication although his blood pressure and pulse rate are normal.
• D.He is euphoric for about an hour after each injection.

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