Nokea
A client has a new diagnosis of GERD. Which of the following statements should the nurse include in the teaching about dietary management?
- A. You should increase your intake of high-fat foods.
- B. You should decrease your intake of high-fat foods.
- C. You should avoid foods that contain gluten.
- D. You should increase your intake of dairy products.
Correct Answer: B
Rationale: The correct answer is to decrease the intake of high-fat foods. High-fat foods can exacerbate symptoms of GERD by delaying stomach emptying and increasing the risk of reflux. By reducing high-fat foods in the diet, the client can help manage symptoms of GERD and decrease the likelihood of complications. Choice A is incorrect because increasing high-fat foods can worsen GERD symptoms. Choice C is unrelated as gluten is not a specific concern for GERD. Choice D is incorrect as increasing dairy products may lead to increased fat intake, which is not recommended for GERD.
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Which of the following behaviors by Nurse Jane Robles demonstrates that she understands well the elements of effecting charting?
- A. She signs her charting as follows: J.R
- B. She writes in the chart using a no. 2 pencils.
- C. She noted: appetite is good this afternoon.
- D. She signs on the medication sheet after administering the medication.
Correct Answer: D
Rationale: Effective charting requires accuracy, clarity, and accountability, adhering to legal and professional standards. Signing the medication sheet after administering medication, as Nurse Jane does, exemplifies this by confirming the intervention occurred, ensuring patient safety, and providing a verifiable record. This practice aligns with the 'Five Rights' of medication administration and reduces error risks, such as double-dosing. Conversely, signing as 'J.R.' lacks full identification (name and title), compromising accountability. Using a pencil risks erasure or alteration, undermining record integrity, as permanent ink is standard. Noting 'appetite is good' is subjective and lacks detail (e.g., meal percentage consumed), reducing its clinical value. Nurse Jane's action of signing post-medication administration reflects a strong grasp of charting's role in care continuity and safety, making it the best demonstration of effective documentation principles.
Which of the following statement is TRUE about objective data?
- A. Reported by the client
- B. Observed by the nurse
- C. Always subjective
- D. All of the above
Correct Answer: B
Rationale: Objective data is observed by the nurse (B), per assessment e.g., rash. Not reported (A), not subjective (C), not all (D) measurable. B truly defines objective's basis, making it correct.
A client with a traumatic brain injury has an intracranial pressure (ICP) of $15 \mathrm{mmHg}$ and a mean arterial pressure (MAP) of $90 \mathrm{mmHg}$. What is the cerebral perfusion pressure (CPP)?
- A. 65 mmHg
- B. 75 mmHg
- C. 85 mmHg
- D. 95 mmHg
Correct Answer: B
Rationale: CPP = MAP - ICP; 90 - 15 = 75 mmHg (B). Other options (A, C, D) miscalculate. B is correct. Rationale: CPP of 75 mmHg is within normal (60-100), ensuring brain perfusion, per neurocritical care, critical for TBI outcomes.
In a 24 hour urine specimen started Friday, 9:00 A.M, which of the following if done by a Nurse indicate a NEED for further procedural debriefing?
- A. The nurse ask the client to urinate at 9:00 A.M, Friday and she included the urine in the 24 hour urine specimen
- B. The nurse discards the Friday 9:00 A M urine of the client
- C. The nurse included the Saturday 9:00 A.M urine of the client to the specimen collection
- D. The nurse added preservatives as per protocol and refrigerates the specimen
Correct Answer: A
Rationale: Including 9:00 AM Friday urine pre-start skews 24-hour totals (9 AM Fri-Sat); it's discarded. Discarding start, including end, preserving are correct. Nurses need debrief e.g., timing for accuracy, per standards.
The nurse manager is conducting an educational session for the nurses on non-selective beta-adrenergic blockers ( $\beta$ blockers). How should the nurse manager accurately describe the mechanism of action of these medications? List the options in order from first to last.
- A. Heart rate and blood pressure are decreased
- B. Epinephrine and norepinephrine actions are blocked
- C. Betaâ‚ and betaâ‚‚ receptor sites are blocked
- D. Cardiac workload and oxygen demand decreases
Correct Answer: C
Rationale: Non-selective beta-adrenergic blockers (e.g., propranolol) inhibit the sympathetic nervous system's effects on betaâ‚ (heart) and betaâ‚‚ (lungs, vessels) receptors. The mechanism sequence is: (1) Betaâ‚ and betaâ‚‚ receptor sites are blocked (C), (2) Epinephrine and norepinephrine actions are blocked (B), (3) Heart rate and blood pressure are decreased (A), (4) Cardiac workload and oxygen demand decreases (D). Blocking beta receptors (C) is the initial step, preventing catecholamines (B) from binding, which reduces heart rate and vasoconstriction (A), ultimately lowering myocardial oxygen demand (D). Incorrect sequencing, like starting with heart rate reduction, skips the pharmacological basis. The CSV requires one answer, so C is chosen as the foundational step. Rationale: Beta blockade directly inhibits receptor activation, a primary action taught in pharmacology education, leading to downstream effects critical for conditions like hypertension or angina, ensuring nurses understand the drug's systemic impact.