Nokea
A 10-year-old weighs 99 lb (44.9 kg) and has a BMI of 24.8 kg/m² (>95th percentile). The licensed practical nurse (LPN) is collaborating with the registered nurse (RN) to formulate a weight loss plan. Which is most important for the nurse to determine?
- A. Child's pattern of daily physical activity
- B. Family's eating habits
- C. Family's financial resources for purchasing healthy foods
- D. Family's readiness for change
Correct Answer: D
Rationale: The family's readiness for change is critical, as it determines their willingness to adopt and sustain lifestyle changes necessary for weight loss. While activity, eating habits, and finances are important, motivation drives success.
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A nurse who is a native English speaker admits an elderly Mexican-American migrant worker after an accident that occurred during work. To facilitate communication the nurse should initially
- A. Request a Spanish interpreter
- B. Speak through the family or co-workers
- C. Use pictures, letter boards, or monitoring
- D. Assess the client's ability to speak English
Correct Answer: D
Rationale: Assess the client's ability to speak English. Despite the cultural heritage, the nurse cannot make assumptions. Stereotyping is to be avoided. The nurse should assess the client's comfort and ability in speaking English.
A client is admitted with suspected pheochromocytoma. The physiological alteration associated with pheochromocytoma is:
- A. An extreme elevation in blood pressure
- B. Petechial rash across the chest and axilla
- C. White flecks in the iris
- D. Yellow creases at the nasolabial folds
Correct Answer: A
Rationale: Pheochromocytoma causes catecholamine release, leading to extreme hypertension . Rash , iris flecks , and nasolabial creases are not associated.
The parents of a 4 year-old hospitalized child tell the nurse, 'We are leaving now and will be back at 6 PM.' A few hours later the child asks the nurse when the parents will come again. What is the best response by the nurse?
- A. They will be back right after supper.'
- B. In about 10 years, you will see them.'
- C. After you play awhile, they will be here.'
- D. When the clock hands are on 6 and 12.'
Correct Answer: A
Rationale: Time is not completely understood by a 4 year-old. Preschoolers interpret time with their own frame of reference. Thus, it is best to explain time in relationship to a known, common event.
A client is admitted with right lower quadrant pain, nausea, and a temperature of 100°F. What does the nurse expect will be done initially?
- A. X-ray of the abdomen
- B. Deep palpation of the abdomen
- C. Blood drawn for complete blood count (CBC)
- D. Administration of a tap water enema
Correct Answer: C
Rationale: Symptoms suggest appendicitis; a CBC is initial to assess for infection (elevated WBC), guiding further diagnostic steps.
The nurse is reviewing dietary teaching with a client who has chronic kidney disease. Which of the following statements by the client would indicate a correct understanding of the teaching? Select all that apply.
- A. I am using a salt substitute because I should not use table salt.
- B. I can eat raisin and bran cereal with milk for breakfast.
- C. I drink water,instead of soft drinks or cola. with my meals
- D. I use herbs instead of salt to season my food when cooking meals.
- E. I usually snack on small packages of peanut butter and saline crackers
Correct Answer: D
Rationale: Using herbs instead of salt reduces sodium intake, which is critical in chronic kidney disease to manage fluid retention and blood pressure. Salt substitutes often contain potassium, which is restricted; raisins, bran, and milk are high in potassium or phosphorus; and peanut butter and crackers are high in sodium and phosphorus.