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A client being discharged from the hospital with a diagnosis of gastric ulcer has a prescription for sucralfate 1 gram by mouth 4 times daily. The nurse determines that the client understands proper use of the medication when the client states the intention to take the medication at which time?
- A. With meals and at bedtime
- B. Every 6 hours around the clock
- C. One hour after meals and at bedtime
- D. One hour before meals and at bedtime
Correct Answer: D
Rationale: Sucralfate is an antiulcer medication. The medication should be scheduled for administration 1 hour before meals and at bedtime. This timing will allow the medication to form a protective coating over the ulcer before it becomes irritated by food intake, gastric acid production, and mechanical movement. The other options are incorrect.
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The nurse is assessing a client with suspected appendicitis. Which test should the nurse perform to confirm the diagnosis?
- A. Rovsing's sign
- B. Murphy's sign
- C. Psoas sign
- D. Both A and C
Correct Answer: D
Rationale: Rovsing's sign (pain in the right lower quadrant with left-sided pressure) and psoas sign (pain with leg extension) support an appendicitis diagnosis.
An infant with increased intracranial pressure (ICP) on a regular diet vomits while eating dinner. Which of the following should the nurse do next?
- A. Put the child on nothing-by-mouth (NPO) status.
- B. Call to report this event to the physician.
- C. Wait a few minutes, then refeed the child.
- D. Administer the prescribed antiemetic.
Correct Answer: B
Rationale: Vomiting in an infant with increased ICP may indicate worsening pressure, requiring immediate physician notification.
A client with a diagnosis of chronic kidney disease is prescribed a low-phosphorus diet. Which of the following foods should the nurse instruct the client to avoid?
- A. White bread.
- B. Chicken.
- C. Milk.
- D. Apples.
Correct Answer: C
Rationale: Milk is high in phosphorus and should be avoided in a low-phosphorus diet for chronic kidney disease.
Which statement about targeted assessments is accurate?
- A. The need for a targeted assessment is based on the application of the nurse's knowledge of pathophysiology and the presenting symptoms.
- B. The need for a targeted assessment is based on the application of the nurse's knowledge of developmental needs and developmental delays.
- C. Targeted assessment is done on an annual basis for existing clients rather than a complete assessment that is done for new clients.
- D. Targeted assessments consist of a brief medical history and a complete assessment consists of a complete health history and a complete physical assessment.
Correct Answer: A
Rationale: Targeted assessments focus on specific health issues based on the nurse's knowledge of pathophysiology and the patient's presenting symptoms, allowing for a focused evaluation rather than a comprehensive one.
Which couple is at greatest risk for domestic violence?
- A. A couple which consists of a husband and wife both of whom are affected with Alzheimer's disease
- B. A poverty stricken couple without any healthcare resources in the community
- C. A pregnant woman and a husband who was physically abused as a young child
- D. A wealthy couple with feelings that they are immune from punishment and above the law
Correct Answer: C
Rationale: A history of childhood physical abuse is a significant risk factor for perpetrating domestic violence, as it may lead to learned behaviors or unresolved trauma. Pregnancy can also increase stress and vulnerability, further elevating the risk.