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A client who has been diagnosed with gastroesophageal reflux disease (GERD) complains of heartburn. To decrease the heartburn, the nurse should instruct the client to eliminate which of the following items from the diet?
- A. Lean beef.
- B. Air-popped popcorn.
- C. Hot chocolate.
- D. Raw vegetables.
Correct Answer: C
Rationale: Hot chocolate contains caffeine and fat, both of which can relax the lower esophageal sphincter and worsen GERD-related heartburn. The other options are less likely to trigger symptoms.
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A client with a history of systemic lupus erythematosus was admitted with a severe viral respiratory tract infection and diffuse petechiae. Based on these data, it is most important that the nurse further evaluate the client's recent:
- A. Quality and quantity of food intake.
- B. Type and amount of fluid intake.
- C. Weakness, fatigue, and ability to get around.
- D. Length and amount of menstrual flow.
Correct Answer: D
Rationale: Systemic lupus erythematosus (SLE) can cause thrombocytopenia, and diffuse petechiae suggest a low platelet count. Heavy menstrual bleeding is a common manifestation of thrombocytopenia in women and should be evaluated to assess the extent of bleeding and guide treatment. Food, fluid intake, and fatigue are less directly related to the petechiae.
The nurse observes a constant gentle bubbling in the water-seal column of a water-seal chest drainage system. This observation should prompt the nurse to do which of the following?
- A. Continue monitoring as usual; this is expected.
- B. Check the connectors between the chest and drainage tubes and where the drainage tube enters the collection bottle.
- C. Decrease the suction to -15 cm H2O and continue observing the system for changes in bubbling during the next several hours.
- D. Drain half of the water from the water-seal chamber.
Correct Answer: B
Rationale: Constant gentle bubbling in the water-seal column suggests an air leak; checking connectors identifies the source. Expected bubbling is intermittent. Adjusting suction or draining water is inappropriate.
A client's husband expresses concern that his dying wife keeps saying, 'I have to go to the store.' Which of the following statements by the nurse will be most effective in assisting the husband to understand the dying process?
- A. Many dying clients are restless and can be treated with sedatives.
- B. The client may be fighting death and you should leave her alone.
- C. Comments related to going somewhere or leaving on a trip are common in dying clients.
- D. Decreased circulation and lack of oxygen to the brain often causes delirium.
Correct Answer: C
Rationale: Statements about leaving or going somewhere are common in dying clients, reflecting their subconscious preparation for death, and this explanation helps the husband understand the behavior.
A client post-ureteroscopy reports burning on urination. The nurse should:
- A. Encourage fluids.
- B. Administer antibiotics.
- C. Apply a heating pad.
- D. Notify the physician.
Correct Answer: A
Rationale: Burning is common post-ureteroscopy; fluids dilute urine, reducing irritation.
The primary healthcare provider (PHCP) prescribes medication via the buccal route. To correctly administer this medication, the nurse plans to place the medication
- A. in the client's ear while holding the pinna down and back.
- B. under the client's tongue.
- C. in the client's mouth toward the cheek.
- D. into the client's nasal passage.
Correct Answer: C
Rationale: Buccal administration involves placing the medication in the cheek pouch for absorption through the oral mucosa.