Nokea
A client is diagnosed with hyperphosphatemia caused by hypoparathyroidism. To prevent worsening of the condition, the nurse should instruct the client to avoid which food selections? Select all that apply.
- A. Fish
- B. Eggs
- C. Coffee
- D. Grapes
- E. Bananas
- F. Whole-grain breads
Correct Answer: A,B,F
Rationale: Food items and liquids that are naturally high in phosphates include fish, eggs, milk products, whole grains, vegetables, and carbonated beverages, and they should be avoided by the client with hyperphosphatemia. Coffee, grapes, and bananas are acceptable for this client to consume because their phosphate levels are not significant.
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A client diagnosed with Parkinson's disease has begun therapy with levodopa. The nurse determines that the client understands the action of the medication if the client verbalizes that results may not be apparent for what period of time?
- A. 1 week
- B. 24 hours
- C. 5 to 7 days
- D. 2 to 3 weeks
Correct Answer: D
Rationale: Levodopa takes 2 to 3 weeks to show results in Parkinson's disease, as it gradually increases dopamine levels to alleviate symptoms. Shorter time frames (24 hours, 5 to 7 days, 1 week) are unrealistic for noticeable improvement.
The nurse provides discharge instructions to the mother of a child who was hospitalized for heart surgery. Which instruction should the nurse provide to the mother?
- A. The child can play outside for short periods of time.
- B. After bathing, rub lotion and sprinkle powder on the incision.
- C. The child may return to school 1 week after hospital discharge.
- D. Notify the primary health care provider if the child develops a fever greater than 100.5°F (38°C).
Correct Answer: D
Rationale: Notifying the primary health care provider if the child develops a fever greater than 100.5°F (38°C) is critical to detect potential infections post-heart surgery. The child should not play outside for several weeks to avoid infection or injury. No creams, lotions, or powders should be applied to the incision until fully healed. The child should not return to school until 3 weeks after discharge, starting with half days.
The school nurse teaches an athletic coach how to prevent dehydration among athletes practicing in the hot weather. What is the best advice for the nurse to give to the coach?
- A. Drink plenty of fluids before and after practice.
- B. Have the athletes take a salt tablet before practice.
- C. Reschedule practice for before school and after sunset.
- D. Provide a fluid break every 30 minutes during practice.
Correct Answer: D
Rationale: Hot weather accelerates the body's loss of fluid and electrolytes during strenuous physical activity, so the nurse encourages the coach to schedule fluid breaks at 30-minute intervals so that the athletes can periodically rest and restore body fluids. Drinking fluid before and after practice is a reasonable suggestion; however, because the hot weather accelerates fluid and electrolyte losses, body fluids must be periodically replenished to maintain the fluid and electrolyte balance. Although a sodium load increases fluid retention, the nurse avoids suggesting salt tablets for the athletes because the nurse needs approval from each athlete's primary health care provider before recommending the salt. Rescheduling practice times is unrealistic.
A client who sustained a thoracic cord injury a year ago returns to the clinic for a follow-up visit, and the nurse notes a small reddened area on the coccyx. The client is not aware of the reddened area. After counseling the client to relieve pressure on the area by adhering to a turning schedule, which action by the nurse is most appropriate?
- A. Teaching the client to feel for reddened areas
- B. Asking a family member to assess the skin daily
- C. Teaching the client to use a mirror for skin assessment
- D. Scheduling the client to return to the clinic daily for a skin check
Correct Answer: C
Rationale: The client should be encouraged to be as independent as possible. The most effective means of skin self-assessment for this client is with the use of a mirror. The redness cannot be felt. Asking a family member to assess the skin daily does not promote independence. It is unnecessary and unrealistic for the client to return to the clinic daily for a skin check.
A client being discharged to home after angioplasty via the right femoral groin has received the catheter insertion site discharge instructions from the nurse. Which client statement indicates that the client understands the instructions?
- A. Coolness or discoloration of the right foot is expected.
- B. I should expect a large area of bruising at the right groin.
- C. Temperature as high as 101°F (38.3°C) is not unusual a few days after the procedure.
- D. Mild discomfort in the right groin may occur, and Tylenol should relieve the pain.
Correct Answer: D
Rationale: The client may feel some mild discomfort at the catheter insertion site after angioplasty. This is usually relieved by analgesics such as acetaminophen (Tylenol). The client is taught to report to the primary health care provider any neurovascular changes to the affected leg; bleeding or bruising at the insertion site; and signs/symptoms of local infection, such as drainage at the site or increased temperature.