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Questions 149

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Question 1 of 5

Which activity is suitable for a client who suffered an uncomplicated myocardial infarction (MI) 2 days ago?

Correct Answer: A

Rationale: Sitting in a chair for short periods is appropriate 2 days post-MI to promote circulation and prevent complications, while ambulation is too strenuous.

Question 2 of 5

When caring for the child with autistic disorder, the nurse should:

Correct Answer: B

Rationale: A consistent caregiver provides stability and reduces anxiety in a child with autism.

Question 3 of 5

A gravida III para II is admitted to the labor unit. Vaginal exam reveals that the client's cervix is 8 cm dilated, with complete effacement. The priority nursing diagnosis at this time is:

Correct Answer: B

Rationale: At 8 cm dilation with complete effacement, the client is in advanced labor, and the risk of precipitate delivery is high, posing a potential for injury.

Question 4 of 5

Which of the following is a characteristic of an ominous periodic change in the fetal heart rate?

Correct Answer: D

Rationale: A recurrent fetal heart rate of 90-100 bpm at contraction ends indicates severe distress, an ominous sign.

Question 5 of 5

A client with prostate cancer has been given the option of various treatments and asks the nurse for advice. Which of the following is the most appropriate response?

Correct Answer: A

Rationale: Discussing options and feelings (
A) supports the client's decision-making without giving direct advice. Other responses (B, C,
D) dismiss the client's request or overstep the nurse's role.

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