A male client has heart failure. He has been instructed to gradually increase his activities. Which signs and symptoms of worsening heart failure should the nurse tell him to watch for that would indicate a need for him to lower his activity level?

• A.Pain in his legs when he walks
• B.Thirst, weight loss, and polyuria
• C.Drowsiness and lethargy after his activities
• D.Weight gain, edema in his lower extremities, and shortness of breath

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A client is in active labor and has been admitted to the labor and delivery unit. The RN has just done a sterile vaginal exam and determines that the client is dilated 5 cm, effaced 85%, and the fetus's head is at 0 station.
She asks if she could have a lumbar epidural now. The epidural is started, and the anesthetic agent used is bupivacaine (Marcaine). After the client has received her lumbar epidural, it is important for the RN to monitor her for which of the following side effects:

• A.Hypertension
• B.Hypotension
• C.Hypoglycemia
• D.Hyperglycemia

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A client has been admitted to the labor and delivery unit in active labor. After assessing her, the RN notes that the client's fetus position is left occipital posterior. Which of the following statements best describes what this means to the labor process:

• A.Decreases the overall time of the labor process
• B.Prolongs the client's first stage of labor
• C.Decreases the time of the client's first stage of labor
• D.Prolongs the client's third stage of labor

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The physician prescribes amitriptyline (Elavil) for a client. What does the patient need to know about this medication?

• A.Prolonged use of this medication will result in extrapyramidal side effects.
• B.When the medication is effective, he will experience no anxiety.
• C.The medication should relieve his symptoms of depression.
• D.Blood must be drawn weekly to test for toxicity.

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The nurse is preparing a 6-year-old child for an IV insertion. Which one of the following statements by the nurse is appropriate when preparing a child for a potentially painful procedure?

• A."Some say this feels like a pinch or a bug bite. You tell me what it feels like."
• B."This is going to hurt a lot; close your eyes and hold my hand."
• C."This is a terrible procedure, so don't look."
• D."This will hurt only a little; try to be a big boy."

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