A client is to have lumbar epidural anesthesia. Which nursing action is appropriate?

Correct Answer: C

Rationale: The correct answer is C because infusing 500 to 1000 mL of a crystalloid intravenous solution is appropriate to maintain hydration and fluid balance during lumbar epidural anesthesia. This helps prevent hypotension and supports renal function. A: Citric acid/sodium citrate is used to prevent blood clotting during dialysis, not for epidural anesthesia. B: Promethazine is an antiemetic and antihistamine, not indicated for epidural anesthesia. D: Rh0(D) immune globulin injection is used to prevent Rh incompatibility in pregnancy, not relevant to lumbar epidural anesthesia.

Correct Answer: C

Rationale: The correct answer is C because assessing patient reliability in taking an oral pill daily is crucial for the effectiveness of the progestin-only pill. This method requires strict adherence to a daily regimen. Asking about past childbirth (A) is not directly relevant to assessing candidacy. Assessing regular periods (B) may be important but not as critical as daily pill-taking reliability. Inquiring about past smoking habits (D) is important for overall health but not specific to progestin-only pill candidacy.

Correct Answer: B

Rationale: The correct answer is B: The patient should be using some form of contraception to avoid pregnancy. This is the most important nursing advice because even though the patient is experiencing irregular periods and may be in perimenopause, there is still a risk of pregnancy until menopause is confirmed. Providing advice on contraception is crucial to prevent an unplanned pregnancy at this stage. Choice A is incorrect because hormone therapy is not just used for hot flashes and vaginal dryness; it can also help manage other perimenopausal symptoms. Choice C is incorrect as a dual-energy X-ray absorptiometry scan is not the most immediate concern for this patient. It may be relevant to assess bone density in the future, but contraception should be addressed first. Choice D is incorrect because herbal supplementation may not be the safest or most effective way to manage perimenopausal symptoms, and it does not address the risk of pregnancy.

Correct Answer: B

Rationale: The correct answer is B: LH. LH, or luteinizing hormone, is primarily responsible for triggering ovulation by stimulating the release of the mature egg from the ovary. FSH (A) helps in the development of the egg, but LH is the hormone that actually induces ovulation. Progesterone (C) and Estrogen (D) are important in the menstrual cycle and pregnancy, but they do not directly trigger ovulation.

Correct Answer: C

Rationale: The correct answer is C: Acrosome. The acrosome is a structure located at the head of the sperm that contains enzymes necessary for penetrating the ovum during fertilization. These enzymes help dissolve the protective layers surrounding the ovum, allowing the sperm to enter and fertilize the egg. Choice A: Head is incorrect because the head of the sperm contains the nucleus with genetic material, not the enzymes needed for penetration. Choice B: Tail is incorrect as it is responsible for providing motility to the sperm, not for penetration. Choice D: Midpiece is incorrect as it contains mitochondria that provide energy for the sperm's movement, not enzymes for penetrating the ovum.