A nurse is teaching a client who has a new prescription for doxepin. Which of the following instructions should the nurse include in the teaching?

A. Administer propranolol IV to the client: Propranolol is a beta-blocker used to treat hypertension and certain cardiac conditions. It is not indicated for sudden nausea during pregnancy and could be harmful if administered without cause.
B. Position the client on her side: At 36 weeks, the gravid uterus can compress the inferior vena cava when the client lies flat, reducing venous return and causing supine hypotensive syndrome, which often presents as nausea. Turning the client to her side relieves pressure and restores circulation.
C. Ask the client to increase her daily calcium intake: Calcium is important during pregnancy, especially for bone health, but increasing intake is not an acute intervention for nausea caused by positional blood flow issues.
D. Use Leopold maneuvers to determine the fetal position: Leopold maneuvers assess fetal position but do not address the client’s immediate symptom of nausea, which may indicate compromised circulation from lying supine. Position change is the priority action.

A. Wart-like texture: A wart-like texture is more typical of squamous cell carcinoma or benign lesions like seborrheic keratosis. Melanomas usually do not have a rough, wart-like surface.
B. Firm and rubbery: Firm, rubbery nodules are more consistent with benign skin growths such as dermatofibromas. Melanomas tend to have irregular texture and color rather than a uniform firmness.
C. A central crater with rolled borders: This description fits basal cell carcinoma, which often presents with a pearly nodule and central ulceration. Melanomas do not commonly have this crater-like appearance.
D. Asymmetric with variegated ring: Melanomas are typically asymmetric with uneven, irregular borders and multiple colors. This variegation and asymmetry are classic warning signs distinguishing melanoma from other lesions.