Nokea
A 10-year-old child has been diagnosed with type 1 diabetes mellitus. What instruction should the nurse provide concerning the monitoring of the child's insulin needs?
- A. The child should be taught to self-monitor insulin needs.
- B. The parents will need to be available to monitor the child's insulin needs.
- C. The child's school teacher will assume responsibility of insulin need monitoring.
- D. Friends and family will need to be involved with monitoring the child's insulin needs.
Correct Answer: A
Rationale: Most children 9 years old or older can understand the principles of monitoring their own insulin requirements. They are usually responsible enough to determine the appropriate intervention needed to maintain their health. Parents, friends, and family cannot always be available. The school teacher should not be expected to take responsibility for health care interventions.
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The student nurse is listening to an orthopedic lecture on preoperative education and knee surgeries. Which statement by the student nurse indicates that the teaching has been effective?
- A. Crutch walking instructions should be scheduled before surgery.
- B. Crutch walking instructions should be given on the first postoperative day.
- C. Crutch walking instructions should be scheduled on the second postoperative day.
- D. Crutch walking instructions should be scheduled at the time of discharge after surgery.
Correct Answer: A
Rationale: It is best to assess crutch-walking ability and instruct the client with regard to the use of the crutches before surgery because this task can be difficult to learn when the client is in pain and not used to the imbalance that may occur after surgery. None of the remaining options are appropriate times to teach a client about crutch walking.
Cholestyramine is prescribed, and the nurse provides instructions to the client about the medication. Which client statement indicates a need for further teaching?
- A. I should take this medication with meals.
- B. I need to mix the medication with juice or applesauce.
- C. I should increase my fluid intake while taking this medication.
- D. I should call my primary health care provider immediately if it causes constipation.
Correct Answer: D
Rationale: Common side effects of cholestyramine include constipation, nausea, indigestion, and flatulence. Therefore, it is not necessary to contact the primary health care provider immediately if constipation occurs. Cholestyramine must be administered with food to be effective. This medication should not be taken dry, and it can be mixed in water, juice, carbonated beverages, applesauce, or soup. Increasing fluids will minimize the constipating effects of the medication.
The nurse has provided instructions to a client who is receiving external radiation therapy. Which statement by the client indicates a need for further teaching regarding self-care related to the radiation therapy?
- A. I need to eat a high-protein diet.
- B. I need to avoid exposure to sunlight.
- C. I need to wash my skin with a mild soap and pat it dry.
- D. I need to apply pressure on the irritated area to prevent bleeding.
Correct Answer: D
Rationale: The client receiving external radiation therapy should avoid pressure on the irritated area and wear loose-fitting clothing. Specific health care provider instructions would be necessary to obtain if an alteration in skin integrity occurred as a result of the radiation therapy. The remaining options are accurate measures regarding radiation therapy.
The nurse is reviewing written medication instructions with a client who is prescribed colestipol hydrochloride. Which statement by the client indicates that the teaching has been effective?
- A. Vitamin C will help control unintended side effects.
- B. Vitamin B12 will help control unintended side effects.
- C. B-complex vitamins will help control unintended side effects.
- D. Fat-soluble vitamins will help control unintended side effects.
Correct Answer: D
Rationale: Colestipol hydrochloride, which is a bile-sequestering agent, is used to lower blood cholesterol levels. However, the bile salts (which are rich in cholesterol) interfere with the absorption of the fat-soluble vitamins A, D, E, and K, as well as folic acid. With ongoing therapy, the client is at risk for the deficiency of these vitamins and is counseled to take them as supplements.
The nurse has completed diet teaching for a client on a low-sodium diet for the treatment of hypertension. Which statement by the client should indicate to the nurse that there is a need for further teaching?
- A. Frozen foods are usually lowest in sodium.
- B. This diet will help lower my blood pressure.
- C. This diet is not a replacement for my antihypertensive medications.
- D. The reason I need to lower my salt intake is to reduce fluid retention.
Correct Answer: A
Rationale: A low-sodium diet is used as an adjunct to antihypertensive medications for the treatment of hypertension. Sodium retains fluid, which leads to hypertension as a result of increased fluid volume. Frozen foods use salt as a preservative, which increases their sodium content. Canned foods are extremely high in sodium. Fresh foods are best.