163) A clinic nurse is instructing a pregnant client regarding dietary measures to promote a healthy pregnancy. The nurse tells the client about the importance of an adequate daily fluid intake. Which client statement best indicates an understanding of the daily fluid requirement?
1. "I should drink 12 glasses of fruit juices and milk every day."
2. "I should drink 8 to 10 glasses of fluid a day, and I can drink as many diet soft drinks as I want."
3. "I should drink 12 glasses of fluid a day, and I can include the coffee or tea that I drink in the count."
4. "I should drink at least 8 to 10 glasses of fluid each day, of which at least 6 glasses should be water
Correct Answer:4，The nurse should instruct the client to have an adequate fluid intake daily to assist in digestion and in the management of constipation. The pregnant client should consume at least 8 to 10 (8-oz) glasses of fluid each day, of which at least 6 glasses should be water. It is not necessary for the client to drink 12 glasses of fruit juices and milk every day. Because of their sodium content, diet soft drinks should be consumed in moderation. Caffeinated beverages have a diuretic effect, which may be counterproductive to increasing fluid intake.
164) A client receiving long-term therapy with lithium carbonate (Lithobid) exhibits muscle tremors, confusion, vomiting, and diarrhea. The nurse anticipates that the results of the latest test of the serum lithium level will be between which laboratory value range?
1. 0 and 0.5 mEq/L
2.0.6 and 1.0 mEq/L
3. 1.0 and 1.3 mEq/L
4. 1.5 and 2.0 mEq/L
Correct Answer:4，The therapeutic serum level of lithium is 0.6 to 1.2 mEq/L. Serum lithium concentrations of 1.5 to 2.0 mEq/L may produce a variety of symptoms, including vomiting, diarrhea, drowsiness, incoordination, coarse hand tremors, muscle tremors, and mental confusion.
165) During the termination phase of the nurse-client relationship, the clinic nurse observes that the client has made several sarcastic remarks and has an angry affect. Which is the most appropriateinterpretation of the client's behavior?
1. The client needs to be admitted to the hospital.
2.The client needs to be referred to the psychiatrist as soon as possible.
3. The client requires further treatment and is not ready to be discharged.
4. The client is displaying typical behaviors that can occur during termination.
Correct Answer:4，In the termination phase of a relationship, it is normal for a client to demonstrate a number of regressive behaviors that can be disturbing to the nurse. Typical behaviors include return of symptoms, anger, withdrawal, and minimizing the relationship. The anger that the client is experiencing is a normal feeling during the termination phase and does not necessarily indicate the need for hospitalization or treatment.