A 30-year-old client in the third trimester of her pregnancy asks the nurse for advice about upper respiratory discomforts. She complains of nasal stuffiness and epistaxis, most noticeable on the left side. Which reply by the nurse is correct?

• A."It sounds as though you are coming down with a bad cold. I'll ask the doctor to prescribe a decongestant for relief of symptoms."
• B."A good vaporizer will help; avoid the cool air kind. Also, try saline nose drops, and spend less time on your left side."
• C."These discomforts are all a result of increased blood supply; one of the pregnancy hormones, estrogen, causes them."
• D."This is most unusual. I'm sure your obstetrician will want you to see an ENT (ear, nose, throat) specialist."

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A client is being discharged from the hospital today. The discharge teaching for care of her colostomy included which of the following basic principles for protecting the skin around her stoma:

• A.Taping a pouch that is leaking
• B.Cutting the skin barrier 112 inches larger than the stoma
• C.Changing the pouch only when leakage occurs
• D.Using a skin sealant under pouch adhesives

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A 56-year-old psychiatric inpatient has had recurring episodes of depression and chronic low self-esteem. She feels that her family does not want her around, experiences a sense of helplessness, and has a negative view of herself. To assist the client in focusing on her strengths and positive traits, a strategy used by the nurse would be to:

• A.Tell the client to attend all structured activities on the unit
• B.Encourage or direct client to attend activities that offer simple methods to attain success
• C.Increase the client's self-esteem by asking that she make all decisions regarding attendance in group activities
• D.Not allow any dependent behaviors by the client because she must learn independence and will have to ask for any assistance from staff

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A 2-month-old infant is receiving IV fluids with a volume control set. The nurse uses this type of tubing because it:

• A.Prevents administration of other drugs
• B.Prevents entry of air into tubing
• C.Prevents inadvertent administration of a large amount of fluids
• D.Prevents phlebitis

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A client's transfusion of packed red blood cells has been infusing for 2 hours. She is complaining of a raised, itchy rash and shortness of breath. She is wheezing, anxious, and very restless. The nurse knows these assessment findings are congruent with:

• A.Hemolytic transfusion reaction
• B.Febrile transfusion reaction
• C.Circulatory overload
• D.Allergic transfusion reaction

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