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A client who has a new diagnosis of type 2 diabetes mellitus is being taught about foot care by a nurse. Which of the following statements should the nurse include?
- A. Use lotion on your feet to prevent dry, cracked skin, avoiding application between the toes.
- B. Avoid soaking your feet in warm water daily to prevent dry skin.
- C. Trim your toenails straight across to prevent injury.
- D. Do not apply a heating pad to your feet if they feel cold.
Correct Answer: C
Rationale: The correct answer is C. Trimming toenails straight across is essential for clients with diabetes to prevent the risk of ingrown toenails and injury. Using lotion on feet can be beneficial but should not be applied between the toes to avoid moisture buildup, which can lead to infections. Soaking feet in warm water can lead to dry skin, increasing the risk of cracks and other complications. Applying a heating pad to feet when they feel cold is not recommended for clients with diabetes due to impaired sensation, which can result in burns and other injuries.
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A nurse is preparing to administer an IV medication to a client who reports a latex allergy. Which of the following actions should the nurse take?
- A. Place the client in a supine position.
- B. Use non-latex gloves when administering the medication.
- C. Use latex-free syringes when administering the medication.
- D. Administer the medication through a latex-free IV port.
Correct Answer: D
Rationale: The correct action the nurse should take when preparing to administer an IV medication to a client with a latex allergy is to administer the medication through a latex-free IV port. This measure helps prevent allergic reactions in clients with a known latex allergy. Placing the client in a supine position (Choice A) is not directly related to preventing a latex allergy reaction. Using non-latex gloves (Choice B) is important for protecting the nurse or caregiver from latex exposure but does not prevent the client's allergic reaction. While using latex-free syringes (Choice C) is a good practice, ensuring the IV port is latex-free is more crucial in preventing an allergic response in the client.
A nurse is providing teaching about folic acid to a client who is primigravida. Which of the following information should the nurse include in the teaching?
- A. You should take folic acid to prevent neural tube defects in your baby.
- B. You should consume at least 400 micrograms of folic acid daily.
- C. You can increase your dietary intake of folic acid by consuming cereals and citrus fruits.
- D. You should expect improved energy levels when taking folic acid supplements.
Correct Answer: C
Rationale: The correct answer is C. Folic acid helps prevent neural tube defects, and dietary sources like cereals and citrus fruits are good options to increase folic acid intake. Choice A is incorrect because folic acid is primarily recommended to prevent neural tube defects, not to prevent infections. Choice B is incorrect because the recommended daily intake of folic acid for pregnant women is at least 400 micrograms, not 300. Choice D is incorrect because folic acid is not typically associated with improving energy levels.
A client with chronic kidney disease is receiving dietary teaching from a nurse. Which of the following client statements indicates an understanding of the teaching?
- A. I will increase my intake of bananas.
- B. I will limit my intake of foods high in potassium.
- C. I will increase my intake of protein-rich foods.
- D. I will increase my intake of dairy products.
Correct Answer: B
Rationale: The correct answer is B. Limiting potassium-rich foods is crucial for clients with chronic kidney disease to prevent hyperkalemia, a common complication. Increasing intake of potassium-rich foods like bananas (choice A), protein-rich foods (choice C), or dairy products (choice D) can exacerbate hyperkalemia in these clients. Bananas, protein-rich foods, and dairy products are all high in potassium, which is detrimental for individuals with chronic kidney disease. Therefore, choices A, C, and D are incorrect.
A client has thrombocytopenia. What action should the nurse include?
- A. Encourage the client to floss daily.
- B. Remove fresh flowers from the client's room.
- C. Provide the client with a stool softener.
- D. Avoid serving raw vegetables.
Correct Answer: C
Rationale: The correct action for the nurse when caring for a client with thrombocytopenia is to provide the client with a stool softener. Thrombocytopenia is characterized by a low platelet count, leading to increased bleeding tendencies. Providing a stool softener helps prevent constipation, reducing the likelihood of straining during bowel movements and subsequent bleeding. Encouraging the client to floss daily (choice A) is unrelated to managing thrombocytopenia. Removing fresh flowers from the client's room (choice B) pertains more to infection control than addressing thrombocytopenia. Avoiding serving raw vegetables (choice D) is not directly associated with managing thrombocytopenia symptoms.
A nurse is caring for a client who has chronic kidney disease and a serum potassium level of 6.5 mEq/L. Which of the following actions should the nurse take?
- A. Administer sodium bicarbonate
- B. Administer sodium polystyrene sulfonate
- C. Administer calcium gluconate
- D. Administer calcium carbonate
Correct Answer: B
Rationale: The correct action for the nurse to take is to administer sodium polystyrene sulfonate. This medication promotes potassium excretion and helps lower serum potassium levels in clients with hyperkalemia, which is indicated by a high potassium level. Sodium bicarbonate (choice A) is not used to treat hyperkalemia. Calcium gluconate (choice C) and calcium carbonate (choice D) are used to manage hyperkalemia by stabilizing cell membranes but are not the initial treatment choice for lowering potassium levels.