A client diagnosed with cirrhosis is experiencing pruritus....

A client diagnosed with cirrhosis is experiencing pruritus. Which strategies are appropriate for the nurse to teach the client to promote comfort and skin integrity? Select all that apply.

A. Maintain short fingernails to minimize excoriating the skin
B. Take a bath or shower in hot water to alleviate itching sensations
C. Take prescribed cholestyramine 1 hour after other medications
D. Use a moisturizing cream on unbroken skin daily
E. Wear wool gloves and tight stockings to avoid scratching

Correct Answer: A, C, D

Rationale: Short fingernails (A), cholestyramine timing (C), and moisturizing cream (D) reduce itching and protect skin. Hot water (B) worsens itching, and wool gloves/tight stockings (E) may irritate skin.

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A 13-month-old child is admitted to the pediatric unit with diarrhea and vomiting. The mother tells the nurse that she is worried because her son does not yet walk. She says her other children walked at eight and nine months and asks what could be wrong with this child. How should the nurse respond?

A. All babies are different. It is not abnormal that the baby is not yet walking.'
B. The baby should be walking. I'll let the doctor know he is behind developmentally.'
C. Your son is probably enjoying being the baby and is not eager to grow up and walk.'
D. Walking requires complex coordination. Your son is probably just a little slow to develop this. Don't worry.'

Correct Answer: A

Rationale: Walking typically occurs between 9-18 months; at 13 months, not walking is within normal variation, reassuring the mother without dismissing concerns.

The nurse reinforces education to the parent of a child who was diagnosed with attention-deficit hyperactivity disorder and received a prescription of methylphenidate. Which statement by the parent best demonstrates that teaching has been effective?

A. An additive-free, low-sugar diet will reduce my child's symptoms.'
B. I can now manage my child's condition on my own.'
C. My child should take the last daily dose of methylphenidate before 6:00 PM.'
D. Once the medication is started, I will not have to monitor my child anymore.'

Correct Answer: C

Rationale: Taking methylphenidate before 6:00 PM (C) prevents sleep disruption, indicating effective teaching. Diet changes (A), self-management (B), and no monitoring (D) are incorrect or incomplete.

Which of the following clients does the nurse identify as being at high risk for developing colorectal cancer? Select all that apply.

A. Client who has a diet high in red meat and low in fiber
B. Client who is morbidly obese
C. Client with a 15-year history of ulcerative colitis
D. Client with a 40-year history of cigarette smoking
E. Client with a family history of colorectal cancer

Correct Answer: A, C, E

Rationale: High red meat/low fiber diet (A), ulcerative colitis (C), and family history (E) are established risk factors for colorectal cancer. Obesity (B) and smoking (D) have weaker associations.

A newborn has been diagnosed with hypothyroidism. In discussing the condition and treatment with the family, the nurse should emphasize

A. They can expect the child will be mentally retarded
B. Administration of thyroid hormone will prevent problems
C. This rare problem is always hereditary
D. Physical growth/development will be delayed

Correct Answer: B

Rationale: Administration of thyroid hormone will prevent problems. Early identification and continued treatment with hormone replacement corrects this condition.

The nurse is preparing to administer several medications through a client's feeding tube. None of the medications are extended release. Which of the following actions should the nurse implement? Select all that apply.

A. Combine all medications and administer together
B. Crush each medication separately before administration
C. Determine if the medications are available in liquid form
D. Flush the tube before and after medication administration
E. Mix medications with enteral feeding formula before administration

Correct Answer: B, C, D

Rationale: Crushing separately (B) prevents interactions, liquid forms (C) are preferred, and flushing (D) ensures patency. Combining all medications (A) or mixing with formula (E) can cause clogs or interactions.