Nokea
A client has a new prescription for total parenteral nutrition (TPN). Which of the following actions should the nurse plan to take?
- A. Obtain a random blood glucose daily.
- B. Change the IV tubing every 72 hours.
- C. Apply a new dressing to the IV site every 24 hours.
- D. Weigh the client weekly.
Correct Answer: A
Rationale: When a client is on total parenteral nutrition (TPN), monitoring blood glucose levels daily is crucial to manage and detect complications like hyperglycemia, which can occur due to the high glucose content in TPN solutions. Regular blood glucose monitoring helps the healthcare team adjust the TPN infusion rate to maintain optimal glucose levels and prevent adverse events.
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Studies have shown that about 40% of patients fall out of bed despite the use of side rails; this has led to which of the following conclusions?
- A. Side rails are ineffective
- B. Side rails should not be used
- C. Side rails are a deterrent that prevent a patient from falling out of bed
- D. Side rails are a reminder to a patient not to get out of bed
Correct Answer: A
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
A healthcare provider is planning care for a client who has a new prescription for a high-fiber diet. Which of the following foods should the healthcare provider recommend?
- A. White bread
- B. Canned fruit
- C. Cheese
- D. Brown rice
Correct Answer: D
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
The nurse wants to check the popliteal pulse. This pulse can be better palpated if the nurse does which of the following things?
- A. Ask the client to extend the knee.
- B. Have the client flex the knee.
- C. Press lightly on the right side of the front of the knee.
- D. Palpate more deeply than for other pulses.
Correct Answer: B
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
The nurse should recognize that all of the following physical changes of the head and face are associated with the aging client except:
- A. Pronounced wrinkles on the face
- B. Decreased size of the nose and ears
- C. Increased growth of facial hair
- D. Neck wrinkles
Correct Answer: B
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
The nurse is caring for a client with a history of congestive heart failure. The client's dyspnea has worsened over the past 2 hours. The nurse should:
- A. Increase the oxygen flow rate to 6L per minute
- B. Place the client in high Fowler's position
- C. Administer Lasix (furosemide) immediately
- D. Encourage the client to cough and deep breathe
Correct Answer: B
Rationale: Placing the client in high Fowler's position eases dyspnea in worsening congestive heart failure by reducing preload oxygen adjustment needs orders, Lasix requires confirmation, and coughing won't help acute fluid overload. Nurses prioritize positioning, monitoring respiratory status, aiding comfort in this cardiac emergency.