Choice A rationale:

Hot flashes are not typically associated with postpartum depression; they are more related to hormonal changes.

Choice B rationale:

Intermittent abdominal pain is common after childbirth due to uterine contractions and involution.

Choice C rationale:

Blurred vision is not a typical symptom of postpartum depression.

Choice D rationale:

Feelings of intense guilt are indicative of postpartum depression and require further investigation.

Choice A rationale:

Methylphenidate has been associated with potential growth suppression in children, which is why this statement is important.

Choice B rationale:

Administering the medication at bedtime might interfere with the child's sleep.

Choice C rationale:

Methylphenidate is more likely to cause decreased appetite and weight loss, not weight gain.

Choice D rationale:

Methylphenidate is a stimulant and is more likely to cause increased alertness rather than drowsiness.

Choice A rationale:

Genital herpes can be transmitted through viral shedding even when there are no visible lesions.

Choice B rationale:

Oil-based lubricants can weaken latex condoms, increasing the risk of condom breakage.

Choice C rationale:

Maintaining hydration is important during outbreaks to support the body's immune response.

Choice D rationale:

Acyclovir can help manage outbreaks, but it does not cure the infection.

Choice A rationale:

Aspirin might increase the risk of bleeding, which is a concern during chemotherapy.

Choice B rationale:

Fiber intake should be increased to prevent constipation caused by chemotherapy.

Choice C rationale:

Applying heat to bruised areas might increase bleeding risk.

Choice D rationale:

Chemotherapy can lead to constipation, so taking a stool softenercan help prevent this side effect.

Choice A rationale:

Postoperative pain management is crucial for the client's comfort and recovery.

Choice B rationale:

Excoriated folds of the client's panniculus might be related to skin irritation and can be addressed without immediate provider notification.

Choice C rationale:

Hypoactive bowel sounds can be expected after surgery and might not require immediate reporting.

Choice D rationale:

Urine output of 80 mL in the past hour might be influenced by various factors and is not as high a priority as severe pain.

Choice A rationale:

The recommended course of varenicline is longer than 30 days.

Choice B rationale:

Varenicline should be started 1 week before the client's quit date to allow the medication to reach effective levels.

Choice C rationale:

Drowsiness is not a common side effect of varenicline.

Choice D rationale:

Grapefruit interactions are not typically associated with varenicline.

Choice A rationale:

Inflammatory bowel disease, including Crohn's disease, can lead to decreased albumin levels due to malabsorption and inflammation.

Choice B rationale:

Increased erythrocyte sedimentation rate (ESR) is more likely in inflammatory conditions.

Choice C rationale:

Decreased hematocrit is more common due to potential blood loss.

Choice D rationale:

Decreased protein levels are expected due to inflammation and malabsorption.

Choice A rationale:

A 7-month-old infant with Down syndrome is less likely to use a spoon.

Choice B rationale:

Crawling short distances is a developmental milestone that can be expected at this age.

Choice C rationale:

Speaking five to eight words is not an appropriate milestone for a 7-month-old infant.

Choice D rationale:

Standing with assistance usually occurs around 9-12 months, which might be delayed in infants with Down syndrome.

Choice A rationale:

Urine in acute glomerulonephritis often appears tea-colored or smoky due to hematuria.

Choice B rationale:

Hypertension is common in acute glomerulonephritis.

Choice C rationale:

Fluid retention and subsequent weight gain are common due to decreased kidney function.

Choice D rationale:

Hyponatremia is not typically associated with acute glomerulonephritis.

Choice A rationale:

Assessing for the client's immediate safety is the first priority in crisis intervention.

Choice B rationale:

Identifying social support is important but not the primary action in this situation.

Choice C rationale:

Instructing the client about coping skills is important, but immediate safety takes precedence.

Choice D rationale:

Exploring the client's perception of the event is valuable, but assessing for suicidality is more urgent.

Choice A rationale:

Shaking the auto-injector is not recommended as it could disrupt the medication's effectiveness. Epinephrine auto-injectors contain two separate components that need to be mixed upon injection.

Choice B rationale:

Massaging the injection site after using the auto-injector can actually help disperse the medication and promote absorption and reduce pain and swelling.

Choice C rationale:

Injecting the medication into the top of the thigh is the correct administration site and technique for an epinephrine auto-injector. It's a large muscle area that allows for rapid absorption.

Choice D rationale:

Epinephrine auto-injectors should not be refrigerated, as extreme temperatures can affect their functionality. The client should store the device at room temperature away from light and heat sources.

Choice A rationale:

While some women might experience lighter periods while using hormonal contraceptives, heavier menstrual bleeding is not an expected outcome of using the patch.

Choice B rationale:

The patch should be applied to areas like the upper outer arm, abdomen, buttock, or upper torso. The upper thigh is not recommended as an application site.

Choice C rationale:

The first patch is typically applied on the first day of the menstrual cycle, but it can also be applied within 24 hours of starting the cycle. This timing helps with immediate contraceptive coverage.

Choice D rationale:

Applying a new patch at the same time each day helps maintain a consistent hormonal level, which is important for contraceptive effectiveness.

Choice A rationale:

Scheduling appointments earlier in the day accommodates the client's potential "on" periods when Parkinson's symptoms are better controlled.

Choice B rationale:

Looking down at the feet while walking is a technique that can help improve gait and stability, as Parkinson's disease often affects balance.

Choice C rationale:

Thicker liquids are less likely to cause aspiration in individuals with Parkinson's disease, as they can have difficulty coordinating the muscles needed for swallowing.

Choice D rationale:

Constipation is a common issue in Parkinson's disease due to decreased gastrointestinal motility. However, focusing on dietary fiber and fluid intake is preferred before considering laxatives.

Choice A rationale:

Rest breaks help prevent excessive fatigue, which is important for the client's overall well-being during recovery from a stroke.

Choice B rationale:

Elevated blood pressure can worsen the effects of a stroke. A systolic blood pressure higher than 180 mm Hg should be reported to the provider for prompt intervention.

Choices C rationale:

Administering aspirin for a headache without a medical order and assessment is not advisable. Choice D rationale:

Maintaining the client's head in a midline neutral position promotes proper alignment and blood flow to the brain.

Choice E rationale:

Monitoring vital signs every 4 hours is important, but addressing elevated blood pressure takes priority.

Choice A rationale:

Newborns typically lose some weight after birth, but 15 percent loss would be excessive and concerning. A normal weight loss range is about 5 to 10 percent.

Choice B rationale:

Newborns should be fed on demand rather than adhering to strict schedules to ensure they are adequately nourished.

Choice C rationale:

Breastfeeding requires additional energy, and mothers are generally advised to consume around 500 extra calories a day to support milk production and their own energy needs.

Choice D rationale:

Offering a pacifier before sleep can reduce the risk of sudden infant death syndrome (SIDS), but this recommendation usually starts at around 1 to 2 months of age.

Choice A rationale:

Holding the fork through the entire meal can lead to mindless eating and overeating. The client should put down the fork between bites and chew slowly to savor the food and feel full faster.

Choice B rationale:

Planning meals day by day can be stressful and impractical for the client. The client might not have enough time or resources to prepare healthy meals every day, or might be tempted by unhealthy options when hungry. The client should plan meals ahead of time, such as weekly or monthly, and stock up on nutritious foods that are easy to prepare.

Choice C rationale:

Scheduling three times to eat each day can be too rigid and unrealistic for the client. The client might not feel hungry at the scheduled times, or might feel hungry in between meals and snack

on junk food. The client should listen to their body and eat when they are hungry, but not too hungry. The client should also eat slowly and stop when they are full, but not too full.

Choice D rationale:

Eating off a smaller plate can help reduce the portion size and calorie intake of the client. This is a simple and effective way to manage obesity without feeling deprived or hungry. A smaller plate can also create an illusion of having more food, which can increase the satisfaction of the meal.

Choice A rationale:

Abdominal cramps are not typically associated with opioid intoxication. Choice B rationale:

Opioid intoxication can cause symptoms such as slowed or slurred speech, drowsiness, and altered mental status.

Choice C rationale:

Opioid intoxication often leads to bradycardia (slower heart rate), not tachycardia (faster heart rate).

Choice D rationale:

Diaphoresis (excessive sweating) is a symptom of opioid withdrawal, not intoxication.

Choice A rationale:

Using a disposable adhesive probe when measuring the client's SaO2 is not an intervention that can reduce the exposure of the client to latex, because adhesive probes may contain latex and cause skin reactions. A better option would be to use a non-adhesive probe or a probe cover that is latex-free.

Choice B rationale:

Rationale: Latex sensitivity or allergy can lead to adverse reactions when exposed to latex- containing products, such as blood pressure cuffs. Wrapping the blood pressure cuff in a stockinette helps minimize direct contact between the cuff and the client's skin.

Choice C rationale:

Silicone products are usually considered safe for individuals with latex sensitivity because silicone is a different material. Silicone products are generally safe for clients who are sensitive to latex, unless they have a separate allergy to silicone.

Choice D rationale:

Cleaning vial stoppers for 15 seconds before using them to withdraw-medications for the client is not an intervention that can reduce the exposure of the client to latex, because vial stoppers may be made of latex or rubber and cleaning them does not remove the allergen. A better option would be to use vials that have latex-free stoppers or to avoid puncturing the stoppers with needles.

Choice A rationale:

Allergic reactions to eggs are a concern with some vaccines, but the varicella vaccine is generally considered safe for children with egg allergies.

Choice B rationale:

The varicella vaccine is typically given in two doses, not three. Choice C rationale:

Children should avoid taking aspirin for about 6 weeks after receiving the varicella vaccine to reduce the risk of Reye's syndrome, a rare but serious condition associated with aspirin use during viral infections.

Choice D rationale:

The varicella vaccine is usually administered subcutaneously, not into the muscle.

Choice A rationale:

Infants with osteogenesis imperfecta have fragile bones that can fracture easily. Using pillows or other soft support can help prevent accidental fractures during diaper changes.

Choice B rationale:

Immunizations are important for all infants and should not be withheld, even in the presence of osteogenesis imperfecta.

Choice C rationale:

Blood pressure measurement is not a common concern in infants with osteogenesis imperfecta.

Choice D rationale:

Splints may be used to provide support for the infant's limbs to minimize the risk of fractures.

Choice A rationale:

A contraction stress test is not appropriate in this context and would not address the potential risks associated with the client's symptoms.

Choice B rationale:

The elevated blood pressure and upper abdominal pain suggest potential preeclampsia, a serious complication of pregnancy that can lead to significant maternal and fetal risks. Delivery may be indicated to prevent further complications.

Choice C rationale:

Increasing dietary salt intake is not recommended for managing elevated blood pressure in pregnancy.

Choice D rationale:

Administering ferrous sulfate is unrelated to the client's symptoms and concerns.

Choice A rationale:

Phenytoin should be administered slowly to avoid adverse effects. Infusing 800 mg over 5 minutes is too rapid and can lead to cardiovascular complications.

Choice B rationale:

Rationale: After administering phenytoin via IV, it's important to flush the IV line with normal saline (0.9% sodium chloride) to ensure the medication is fully delivered to the client and to prevent any residual medication from precipitating in the IV line.

Choice C rationale:

Flushing with heparin is not standard practice for administering phenytoin.

Choice D rationale:

Phenytoin should be administered in normal saline, not in D5W (dextrose 5% in water), to avoid precipitation.

Choice A rationale:

Deep breathing exercises can be a relaxation technique, but they don't directly address cognitive reframing.

Choice B rationale:

Using a journal to write down thoughts related to gambling can be useful for self-reflection, but it's not specifically a cognitive reframing technique.

Choice C rationale:

Rewarding oneself for not going to the casino can be part of a behavioral approach to managing gambling disorder, but it's not a cognitive reframing technique.

Choice D rationale:

Cognitive reframing involves identifying and replacing negative or distorted thoughts with positive and more rational thoughts. In the context of gambling disorder, this technique can help the client challenge and change the cognitive patterns that contribute to their gambling behavior.

Choice A rationale:

People with dementia may become disoriented and attempt to leave their homes. Disguising exit doors with posters or camouflage can help prevent wandering and promote safety.

Choice B rationale:

Weighing the client once per month is not directly related to dementia care and safety.

Choice C rationale:

Keeping lights on at night can help prevent falls and confusion in people with dementia.

Choice D rationale:

Offering several food choices prior to meal times can be overwhelming for a person with dementia. A simpler approach may be more appropriate.