A pregnant client with hypertension and cardiac dysrhythmias is admitted to the hospital. Which of the following imbalances should the nurse check for?

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Question 1 of 5

A pregnant client with hypertension and cardiac dysrhythmias is admitted to the hospital. Which of the following imbalances should the nurse check for?

Correct Answer: C

Rationale: Hypomagnesemia (low magnesium levels) should be checked for in a pregnant client with hypertension and cardiac dysrhythmias because magnesium plays a critical role in maintaining normal cardiac function and blood pressure regulation. It can worsen both hypertension and dysrhythmias if deficient. Hypomagnesemia can lead to cardiac arrhythmias, particularly in the setting of existing cardiovascular conditions. Monitoring and addressing magnesium levels is important in managing these conditions and ensuring maternal and fetal well-being during pregnancy. Checking for hypomagnesemia allows for timely intervention and correction to help prevent any complications.

Question 2 of 5

Which of the ff signs may be revealed by a visual examination in a client with tonsillar infection if group A streptococci is the cause?

Correct Answer: A

Rationale: The presence of white patches on the tonsils is a visual sign that may be revealed by a visual examination in a client with a tonsillar infection caused by group A streptococci. These white patches are known as exudates and can be a characteristic feature of streptococcal tonsillitis. These exudates may range in appearance from small white spots to larger patches that cover the tonsils. Additionally, other signs commonly associated with streptococcal tonsillitis may include swollen and red tonsils, fever, sore throat, and sometimes swollen lymph nodes in the neck. It is important to note that definitive diagnosis often requires laboratory testing such as a rapid strep test or throat culture to confirm the presence of group A streptococci.

Question 3 of 5

How does nosocomial pneumonia occur?

Correct Answer: A

Rationale: Nosocomial pneumonia occurs in a healthcare setting. It is a type of pneumonia that is contracted during a hospital stay or other healthcare facilities. The risk of developing nosocomial pneumonia is higher in patients who are already hospitalized due to various medical conditions, surgeries, or use of medical devices like ventilators. The infection can be caused by different types of bacteria, viruses, or fungi present in the healthcare environment. Preventive measures, such as proper hand hygiene, infection control practices, and minimizing the use of invasive devices, are crucial in reducing the incidence of nosocomial pneumonia.

Question 4 of 5

The nurse is reviewing the patient's daily PT and INR levels. The PT level is 26 (normal = 9 to 12 seconds). Which of the ff. actions should the nurse take?

Correct Answer: B

Rationale: A PT level of 26 seconds is significantly above the normal range of 9 to 12 seconds. This indicates that the patient's blood is taking much longer to clot than usual, which may put the patient at risk for bleeding. It is important for the nurse to inform the physician before giving the next dose of warfarin because warfarin is a medication that helps prevent blood clots by thinning the blood. However, in this case, the patient's blood is already thin beyond the target range, so giving the next dose of warfarin without physician guidance may further increase the risk of bleeding. The physician may need to adjust the dose or recommend other interventions to manage the patient's PT levels effectively.

Question 5 of 5

The thymus gland role with the immune system is which of the following?

Correct Answer: D

Rationale: The thymus gland plays a crucial role in the immune system as it is primarily responsible for the maturation and differentiation of T lymphocytes (T cells). T cells are essential for cell-mediated immunity and play a key role in recognizing and attacking pathogens such as bacteria, viruses, and cancer cells. The thymus is where immature T cells mature and undergo education to ensure they can distinguish between self and non-self antigens effectively. This process is crucial for the proper functioning of the immune system to protect the body from infections and diseases.

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