Page 2591 - Saunders Comprehensive Review For NCLEX-RN

Test-Taking Strategy: Note the subject, iron supplementation during pregnancy.
Focus on the words understanding of the instructions. Knowledge of basic principles
related to nutrition during pregnancy will assist in eliminating options 2 and 4. From
the remaining options, remember that iron causes constipation.
Level of Cognitive Ability: Evaluating
Client Needs: Physiological Integrity
Integrated Process: Nursing Process—Evaluation
Content Area: Maternity: Antepartum
Health Problem: Adult Health: Gastrointestinal: Nutrition Problems
Priority Concepts: Client Education; Nutrition
Reference: McKinney et al. (2018), p. 266.

880. Answer: 3

Rationale: Levothyroxine accelerates the degradation of vitamin K–dependent
clotting factors. As a result, the effects of warfarin are enhanced. If thyroid hormone
replacement therapy is instituted in a client who has been taking warfarin, the
dosage of warfarin should be reduced.
Test-Taking Strategy: Focus on the subject, the use of levothyroxine concurrently
with warfarin. Recalling that levothyroxine enhances the effects of warfarin will
direct you to the correct option.
Level of Cognitive Ability: Analyzing
Client Needs: Physiological Integrity
Integrated Process: Nursing Process—Analysis
Content Area: Pharmacology: Endocrine Medications: Thyroid hormones
Health Problem: Adult Health: Endocrine: Thyroid disorders
Priority Concepts: Collaboration; Safety
Reference: Hodgson, Kizior (2018), pp. 674-675.

881. Answer: 1, 2, 4

Rationale: The client should use the positions outlined in options 1, 2, and 4.
These allow for maximal chest expansion. The client should not lie on the back
because this reduces movement of a large area of the client’s chest wall. Sitting is
better than standing, whenever possible. If no chair is available, leaning against a
wall while standing allows accessory muscles to be used for breathing and not
posture control.
Test-Taking Strategy: Focus on the subject, the positions that could alleviate
dyspnea. Remember that upright positions are best. Also, note that options 1, 2, and
4 are comparable or alike in that they all address upright positions.
Level of Cognitive Ability: Applying
Client Needs: Physiological Integrity
Integrated Process: Teaching and Learning
Content Area: Adult Health: Respiratory
Health Problem: Adult Health: Respiratory: Obstructive pulmonary disease
Priority Concepts: Client Education; Gas Exchange
Reference: Ignatavicius, Workman, Rebar (2018), pp. 546, 578.

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