Nokea
A 14-year-old client has been diagnosed with celiac disease after a long history of diarrhea, anemia, and weight loss. What type of diet does the nurse anticipate the client will require?
- A. High protein
- B. Dairy free
- C. Low carbohydrate
- D. Gluten free
Correct Answer: D
Rationale: Celiac disease requires a gluten-free diet (D) to prevent intestinal damage. Other diets (A, B, C) are not specific to celiac.
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A.ls with leukemia is receiving Trimetrexate. After reviewing the client's chart, the physician orders Wellcovorin (leucovorin calcium). The rationale for administering leucovorin calcium to a client receiving Trimetrexate is to:
- A. Treat iron-deficiency anemia caused by chemotherapeutic agents
- B. Create a synergistic effect that shortens treatment time
- C. Increase the number of circulating neutrophils
- D. Reverse drug toxicity and prevent tissue damage
Correct Answer: D
Rationale: Leucovorin calcium is given as a rescue therapy to reverse the toxic effects of trimetrexate, protecting healthy cells from damage.
The nurse has inserted a nasogastric tube and aspirated gastric contents to check the pH with color-coded pH paper. The aspirate is dark brown, and pH measures slightly less than 5 according to the color chart. What does this pH usually indicate?
- A. Gastric aspirate
- B. Intestinal aspirate
- C. Respiratory aspirate
- D. Inconclusive results
Correct Answer: A
Rationale: A pH < 5 with dark brown aspirate indicates gastric placement (A). Intestinal aspirate (B) has pH > 6, respiratory (C) is > 7, and results are conclusive (D).
A client had a total thyroidectomy yesterday. The client is complaining of tingling around the mouth and in the fingers and toes. What would the nurses' next action be?
- A. Obtain a crash cart
- B. Check the calcium level
- C. Assess the dressing for drainage
- D. Assess the blood pressure for hypertension
Correct Answer: B
Rationale: Tingling around the mouth and extremities suggests hypocalcemia, a common complication post-thyroidectomy due to parathyroid gland disturbance, so checking the calcium level is the next action.
An 88-year-old client fractured a hip after a fall in her home. Because of her peripheral vascular disease and asthma, surgery is not an option. The client tells the nurse she does not know how she is going to get better. Which response by the nurse is best?
- A. You'll do just fine.
- B. You can't live alone anymore.
- C. What are you most worried about?
- D. You should get a second opinion.
Correct Answer: C
Rationale: This response encourages the client to express her concerns, allowing the nurse to address specific fears and provide tailored support.
The nurse is providing discharge teaching for the client with leukemia. The client should be told to avoid:
- A. Using oil- or cream-based soaps
- B. Flossing between the teeth
- C. The intake of salt
- D. Using an electric razor
Correct Answer: B
Rationale: Flossing can cause gum bleeding, increasing infection and bleeding risks in leukemia clients with low platelet counts.