Correct Answer: A

Rationale: This instruction will help the client to prevent venous stasis and thrombosis, which are common postoperative complications. Range-of-motion exercises promote blood circulation and prevent muscle atrophy and contractures.
Choice B is wrong because using an incentive spirometer every 4 hours is not related to promoting circulation, but rather to improving lung expansion and preventing atelectasis and pneumonia. Using an incentive spirometer is also important for postoperative clients, but it does not address the question.
Choice C is wrong because remaining on bed rest for 24 hours following the procedure is the opposite of promoting circulation. Bed rest increases the risk of venous stasis, thrombosis, and pulmonary embolism. Postoperative clients should be encouraged to ambulate as soon as possible, unless contraindicated.
Choice D is wrong because placing a pillow under your knees while in bed impairs circulation and increases the risk of thrombosis. Placing a pillow under the knees can cause pressure on the popliteal veins and reduce blood flow. Postoperative clients should avoid this position and keep their legs in a neutral or slightly elevated position.

Correct Answer: A

Rationale: Increasing dietary fiber prevents constipation, a common side effect of hydrocodone, an opioid that slows gastrointestinal motility.
Choice B is incorrect because grapefruit juice can interact with some medications but does not enhance hydrocodone absorption and may increase side effects.
Choice C is incorrect because driving should be avoided while taking hydrocodone, as it can cause drowsiness and impair coordination, regardless of time of day.
Choice D is incorrect because hydrocodone typically causes sedation, not increased energy levels.

Correct Answer: D

Rationale: Reporting insomnia or agitation to the provider is critical, as these are common side effects of bupropion, an antidepressant that stimulates norepinephrine and dopamine, and may require dose adjustment or alternative therapy.
Choice A is incorrect because bupropion is typically taken in the morning or twice daily, as it can cause insomnia if taken at bedtime.
Choice B is incorrect because moderate caffeine intake is generally safe, though excessive caffeine may exacerbate agitation.
Choice C is incorrect because bupropion is more likely to cause weight loss, not weight gain, unlike some other antidepressants.

Correct Answer: A

Rationale: A WBC count of 2,500/mm3 is below the normal range (5,000-10,000/mm3) and indicates leukopenia, a common side effect of chemotherapy that increases infection risk, requiring immediate reporting to the provider for potential interventions like growth factors or antibiotics.
Choice B is wrong because a hemoglobin of 12 g/dL is within the normal range for females (12-16 g/dL) and does not require reporting.
Choice C is wrong because a platelet count of 150,000/mm3 is within the normal range (150,000-400,000/mm3) and does not indicate thrombocytopenia.
Choice D is wrong because a potassium level of 4.0 mEq/L is within the normal range (3.5-5.0 mEq/L) and does not require reporting.

Correct Answer: A

Rationale: Encouraging the client to push with each contraction during the second stage of labor (from full cervical dilation to delivery) is appropriate, as it facilitates fetal descent and delivery, aligning with the client's natural urges to push.
Choice B is wrong because positioning the client supine with legs elevated is not recommended; it can compress the inferior vena cava, reduce uterine blood flow, and impede pushing efforts. Upright or lateral positions are preferred.
Choice C is wrong because applying fundal pressure is not a standard practice and can cause maternal or fetal injury, such as uterine rupture or shoulder dystocia.
Choice D is wrong because instructing the client to hold her breath while pushing (Valsalva maneuver) can decrease oxygen to the fetus and increase maternal fatigue; open-glottis pushing (exhaling while pushing) is preferred.