A female client who has been taking oral contraceptives for the past year comes to the clinic for an annual exam. Which finding is most important for the PN to report to the HCP?

Correct Answer: C

Rationale: Left calf pain could indicate deep vein thrombosis (DVT), a serious side effect of oral contraceptives. Reporting this finding to the healthcare provider is critical for further evaluation and treatment. Breast tenderness and change in menstrual flow are common side effects of oral contraceptives and may not be as urgent as left calf pain. Weight gain of 5 pounds, while noteworthy, is not as concerning as a possible indication of DVT.

Correct Answer: A

Rationale: In this scenario, the correct answer is A) All below. The rationale for this choice is that a vegetarian diet can still provide ample sources of iron to help increase the pregnant woman's hemoglobin levels. By including a variety of iron-rich foods such as green leafy vegetables, oatmeal, lentils, and black beans, the woman can meet her iron requirements without consuming animal products. Option B) Increase green leafy vegetables in the diet is a good choice, as these are rich sources of non-heme iron, which is suitable for vegetarians. However, focusing solely on green leafy vegetables may not provide enough variety in iron sources. Option C) Oatmeal is a good choice for breakfast is partially correct as oats contain iron. However, relying solely on oatmeal for iron may not be sufficient to meet the increased requirements during pregnancy. Option D) Add lentils and black beans to soup is a good suggestion as both are excellent plant-based sources of iron. While this option is beneficial, it alone may not provide the full spectrum of iron-rich foods needed to address the client's low hemoglobin levels adequately. Educationally, this question highlights the importance of understanding different sources of iron in a vegetarian diet and how to support pregnant women in meeting their nutritional needs. It emphasizes the role of a nurse in educating clients on dietary modifications to optimize health outcomes during pregnancy.

Correct Answer: C

Rationale: A palpable buzzing sensation, known as a thrill, over an AV fistula indicates proper functioning. The correct action for the PN is to document that the fistula is intact. Choice A is incorrect because there is no need to loosen the fistula dressing when the thrill is felt. Choice B is incorrect as a bounding pulse is not related to the observed buzzing sensation. Choice D is incorrect because applying pressure is unnecessary when a thrill is present, indicating proper AV fistula function.

Correct Answer: A

Rationale: The correct answer is A: Clubbed nails. Clubbed nails are a significant finding often associated with chronic hypoxia or lung disease. The presence of clubbed nails should be documented for further evaluation. Splinter hemorrhages (Choice B) are tiny areas of bleeding under the nails and are associated with conditions like endocarditis. Longitudinal ridges (Choice C) are common and often a normal finding in older adults. Koilonychia or spoon nails (Choice D) refer to nails that are concave or scooped out, often seen in conditions like iron deficiency anemia or hemochromatosis. These conditions are not typically associated with chronic hypoxia or lung disease, making them less likely findings in this situation.

Correct Answer: D

Rationale: When a client undergoing radiation therapy reports increasing fatigue, it is essential to address this common side effect. Educating the client on the importance of rest and sleep can help manage fatigue and promote recovery. Contacting the healthcare provider or charge nurse immediately may not be necessary unless fatigue is severe and other symptoms are present. Rescheduling the treatment or monitoring vital signs more frequently is not the priority in this situation.