Nokea
A client has mitral stenosis and is a prospective valve recipient. The nurse is instructing the client about health maintenance prior to surgery. Inability to follow which of the following regimens would pose the greatest health hazard to this client at this time?
- A. Medication therapy.
- B. Diet modification.
- C. Activity restrictions.
- D. Dental care.
Correct Answer: A
Rationale: Medication therapy (e.g., anticoagulants, diuretics) is critical to manage symptoms and prevent complications like thromboembolism in mitral stenosis.
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The nurse in the perioperative area is preparing a client for surgery and notices that the client looks sad. The client says, 'I'm scared of having cancer. It's so horrible and I brought it on myself. I should have quit smoking years ago.' What would be the nurse's best response to the client?
- A. It's okay to be scared. What is it about cancer that you're afraid of?'
- B. It's normal to be scared. I would be, too. We'll help you through it.'
- C. Don't be so hard on yourself. You don't know if your smoking caused the cancer.'
- D. Do you feel guilty because you smoked?'
Correct Answer: A
Rationale: Acknowledging fear and exploring specific concerns ('What is it about cancer that you're afraid of?') validates emotions and opens communication. Other responses dismiss feelings, speculate on causation, or focus on guilt, which are less therapeutic.
A client with acute renal failure has edema. The nurse should:
- A. Elevate the legs.
- B. Restrict fluids.
- C. Administer a diuretic.
- D. Increase sodium intake.
Correct Answer: B
Rationale: Fluid restriction helps manage edema in acute renal failure.
A client is in balanced suspension traction using a half-ring Thomas splint with a Pearson attachment that suspends the lower extremity and applies direct skeletal traction for a hip fracture. Which of the following nursing assessments would not be appropriate?
- A. Greater trochanter skin checks.
- B. Pin site inspection.
- C. Neurovascular checks proximal to the splint.
- D. Foot movement evaluation.
Correct Answer: C
Rationale: Neurovascular checks proximal to the splint are less relevant, as distal checks assess circulation and nerve function affected by the fracture and traction.
The nurse has attended a continuing education conference regarding medication administration and meal times. Which statement, if made by the nurse, would indicate correct understanding?
- A. Proton pump inhibitors (PPls) should be given as the client eats their breakfast.
- B. Glucocorticoids should be given on an empty stomach to prevent gastrointestinal irritation.
- C. Rapid-acting insulins should be administered approximately 5-10 minutes before meals
- D. Levodopa-Carbidopa should be administered with a high-protein snack to enhance its absorption.
Correct Answer: C
Rationale: Rapid-acting insulins are administered 5-10 minutes before meals to match glucose spikes.
The client with acute renal failure asks the nurse for a snack. Because the client's potassium level is elevated, which of the following snacks is most appropriate?
- A. A gelatin dessert.
- B. Yogurt.
- C. An orange.
- D. Peanuts.
Correct Answer: A
Rationale: Gelatin dessert is low in potassium, suitable for a client with hyperkalemia, unlike yogurt, oranges, or peanuts.