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The nurse is reinforcing information on dietary management to a group of clients with newly diagnosed type 2 diabetes. Which meal represents the best adherence to the principles of and recommendations for diabetic meal planning?
- A. Baked tilapia with tomato salsa, steamed white rice
- B. Black bean chili with brown rice, mixed greens salad
- C. Grilled chicken breast with baked French fries
- D. Hamburger on a whole wheat bun with lettuce and tomato
Correct Answer: B
Rationale: Baked bean chili with brown rice and salad provides fiber, lean protein, and vegetables, balancing blood sugar. Fries and hamburger buns are higher in simple carbs, less ideal for diabetes control.
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The nurse is caring for a client with an exacerbation of asthma following a viral respiratory illness. When collecting data, the nurse expects to find which clinical characteristics of a severe asthma exacerbation? Select all that apply.
- A. Accessory muscle use
- B. Chest tightness
- C. High-pitched expiratory wheeze
- D. Prolonged inspiratory phase
- E. Tachypnea
Correct Answer: A,B,C,E
Rationale: Severe asthma exacerbations cause accessory muscle use, chest tightness, high-pitched wheezing, and tachypnea due to airway obstruction. Prolonged expiration, not inspiration, is typical as air is trapped.
The nurse is assisting with an education conference for graduate nurses about infant CPR. Which of the following statements are appropriate to include in the teaching? Select all that apply.
- A. A single rescuer responding to an unwitnessed infant arrest should perform 2 minutes of CPR before retrieving a defibrillator
- B. Depth of chest compressions for infants should be half the depth of the anterior-posterior chest diameter
- C. Rescuers should place the heel of one hand on the lower sternum when delivering chest compressions to infants
- D. The ratio of chest compressions to breaths during CPR by a single rescuer is 15:2 for infants
- E. You should assess the infant’s brachial pulse for no longer than 10 seconds
Correct Answer: A,E
Rationale: Two minutes of CPR before defibrillator retrieval and assessing the brachial pulse for ≤10 seconds align with infant CPR guidelines. Compression depth is about one-third the chest, two fingers are used, and the ratio is 30:2 for a single rescuer.
The nurse checks the lab values of a newly admitted client. RBC: 4.0 million/mm³, WBC: 1500/mm³, Platelets: 40,000/mm³. What nursing actions are indicated because of these lab values?
- A. Keep the client on bed rest and protective isolation.
- B. Plan for protective isolation and do not give injections.
- C. Keep the client on bed rest and avoid trauma.
- D. There are no special nursing actions indicated.
Correct Answer: B
Rationale: Low WBC (neutropenia) requires protective isolation, and low platelets (thrombocytopenia) contraindicate injections to prevent bleeding and infection.
The nurse is caring for a client who was admitted for treatment of schizoaffective disorder with visual hallucinations. He tells the nurse that he sees extraterrestrials that are coming to get him. What is the best nursing response?
- A. You know that extraterrestrials are make-believe.'
- B. Call his physician and report this visual hallucination.
- C. Ignore his comment and change the subject.
- D. You think someone is coming after you?'
Correct Answer: D
Rationale: Reflecting the client's statement validates his experience without reinforcing the hallucination, promoting therapeutic communication.
The nurse approaches a 4-year-old boy to administer a medication. The child has no identification armband. Which action is most appropriate?
- A. Check the room and bed number the child is in with the room and bed number on the medication order and administer the medication if they agree
- B. Ask the child what his name is before administering the medication
- C. Ask the child if his name is George (the name on the medication order) and administer the medication if the child says that is his name
- D. Ask the adults at the bedside what the child's name is and administer the medication if the adults verify the name of the child
Correct Answer: D
Rationale: Verifying the child's identity with adults at the bedside ensures safety, as children may not reliably confirm their own identity, and room/bed numbers are not sufficient for identification.