Nokea
A client has undergone a laparoscopic cholecystectomy. Which of the following instructions should the nurse include in the discharge teaching?
- A. Empty the bile bag daily.
- B. Report any bile-colored drainage from the incision.
- C. Resume normal activities immediately.
- D. Avoid pain medications.
Correct Answer: B
Rationale: Laparoscopic cholecystectomy does not involve a bile bag, so option A is incorrect. Patients should monitor for signs of complications, such as bile-colored drainage, which could indicate a bile leak, making option B correct. Resuming normal activities immediately (C) is unsafe due to recovery needs, and avoiding pain medications (D) is unnecessary as pain management is often required.
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A nurse is teaching a camp counselor about the treatment of snake bites to an extremity. Which of the following information should be included in the teaching?
- A. apply a tourniquet above the affected site
- B. keep the extremity elevated above the heart
- C. if possible, try to capture the snake for easy identification
- D. do not apply ice to the affected site
Correct Answer: D
Rationale: Applying ice can cause tissue damage and is not recommended. Tourniquets (A) can worsen outcomes, elevation above the heart (B) is controversial and not universally advised, and capturing the snake (C) is unsafe and unnecessary with modern antivenom protocols.
A client is receiving Pentoxifylline (Trental) for intermittent claudication. The nurse should determine the effectiveness of the drug by asking the client:
- A. If he has improved circulation in the legs
- B. If he can wiggle his toes
- C. If he is urinating more frequently
- D. If he is less dizzy
Correct Answer: A
Rationale: Pentoxifylline improves blood flow by reducing blood viscosity and increasing erythrocyte flexibility, alleviating intermittent claudication. Asking about improved leg circulation (e.g., reduced pain or increased walking distance) assesses its effectiveness. Toe movement, urination, and dizziness are unrelated to its therapeutic action.
When admitting a client with a fractured extremity, the nurse should first focus the assessment on which of the following?
- A. The area proximal to the fracture.
- B. The actual fracture site.
- C. The area distal to the fracture.
- D. The opposite extremity for baseline comparison.
Correct Answer: C
Rationale: Assessing distal to the fracture checks for neurovascular compromise, a priority to prevent complications.
The nurse reviews laboratory data for a client with human immunodeficiency virus (HIV) and notes an increased viral load (VL). The nurse reviews the client's current medications and should clarify which medication with the primary healthcare provider (PHCP)?
- A. Acetaminophen
- B. Echinacea
- C. Cetirizine
- D. Calcium carbonate
Correct Answer: B
Rationale: Echinacea, an herbal supplement, may interfere with antiretroviral therapy for HIV, potentially reducing its effectiveness and leading to an increased viral load. Choices A (acetaminophen), C (cetirizine), and D (calcium carbonate) do not have known interactions that significantly impact HIV viral load.
A client who is recovering from a subtotal gastrectomy experiences dumping syndrome. The client asks the nurse, 'When will I be able to eat three meals a day again like I used to?' Which of the following responses by the nurse is most appropriate?
- A. Eating six meals a day is time-consuming, isn't it?'
- B. You will have to eat six small meals a day for the rest of your life.'
- C. You will be able to tolerate three meals a day before you are discharged.'
- D. Most clients can resume their normal meal patterns in about 6 to 12 months.'
Correct Answer: D
Rationale: Most clients can gradually resume a normal meal pattern (three meals a day) within 6 to 12 months as the body adapts post-gastrectomy, making this the most accurate and supportive response.