Nokea
A 70-year-old male client with type 2 diabetes mellitus (DM) is hospitalized with an infected ulcer on his great right toe. Which instruction should the nurse emphasize during discharge teaching?
- A. Check the insides and linings of all enclosed shoes before putting the shoes on
- B. Wash the feet with soap and water, then apply a topical antibiotic ointment.
- C. Trim toenails weekly to prevent injury.
- D. Avoid wearing sandals or open-toed shoes.
Correct Answer: A
Rationale: Preventing trauma to the feet is critical for clients with diabetes to avoid complications like infections and ulcers.
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The nurse is caring for a school-age child who has had a cardiac catheterization. The child tells the nurse that the bandage is “too wet.†The nurse finds the bandage and bed soaked with blood. What is the priority nursing action?
- A. Notify physician
- B. Apply new bandage with more pressure
- C. Place the child in Trendelenburg position
- D. Apply direct pressure above catheterization site
Correct Answer: D
Rationale: If bleeding occurs, direct continuous pressure is applied 2.5 cm (1 inch) above the percutaneous skin site to localize pressure over the vessel puncture. Notifying a physician and applying a new bandage can be done after pressure is applied. The nurse can have someone else notify the physician while the pressure is being maintained. It is not a helpful intervention to place the girl in the Trendelenburg position. It would increase the drainage from the lower extremities.
Regarding bronchial asthma:
- A. Mortality has shown an increase during the past three decades
- B. The incidence is greater in males than females
- C. Nocturnal cough is a recognised feature
- D. Post-RSV bronchial hyperreactivity is strongly associated with atopy
Correct Answer: C
Rationale: Nocturnal cough is a common and recognized feature of bronchial asthma, often disrupting sleep.
In Wolff-Parkinson-White syndrome:
- A. The abnormal pathway is between the atrial and ventricular myocardium
- B. Wide QRS complexes occur more frequently than narrow QRS
- C. Narrow QRS complexes are regular
- D. Verapamil is the treatment of choice for atrial fibrillation
Correct Answer: B
Rationale: In Wolff-Parkinson-White syndrome, a wide QRS complex is often seen due to the presence of an accessory pathway that bypasses the normal conduction system.
Which food is most important for the nurse to encourage a male client with osteomalacia to include in his daily diet?
- A. Fortified milk and cereals
- B. Lean red meat and poultry
- C. Fresh fruits and vegetables
- D. Whole grains and legumes
Correct Answer: A
Rationale: Fortified foods rich in vitamin D and calcium are crucial for the client with osteomalacia to help in bone mineralization.
Which of the following is correct in breast milk jaundice?
- A. Peaks at first week of life
- B. Recurs with resumption of breast milk after trial stoppage
- C. Kernicterus can occur
- D. Seen in up to 10% of infants
Correct Answer: B
Rationale: Breast milk jaundice recurs when breastfeeding is resumed after a temporary stoppage.