Nokea
A client who has chronic lymphocytic leukemia is starting chemotherapy treatments and asks if she needs to make any dietary changes. Which of the following statements by the nurse is appropriate?
- A. Use sugar-free gum if you experience a metallic taste in your mouth.
- B. Drink fluids at mealtime to prevent early satiety.
- C. Foods that are higher in fat can help nausea.
- D. Raw fruits and vegetables will be easier for your body to digest.
Correct Answer: A
Rationale: The correct answer is A. Using sugar-free gum can help alleviate the metallic taste often experienced during chemotherapy treatments. Choices B, C, and D are incorrect. Drinking fluids at mealtime may worsen early satiety, foods higher in fat can exacerbate nausea, and raw fruits and vegetables may be harder for the body to digest and may pose a risk of infection for individuals with compromised immune systems.
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While providing home care to a client with congestive heart failure, the nurse is asked how long diuretics must be taken. What is the nurse's best response?
- A. As you urinate more, you will need less medication to control fluid.
- B. You will have to take this medication for about a year.
- C. The medication must be continued so the fluid problem is controlled.
- D. Please talk to your health care provider about medications and treatments.
Correct Answer: C
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
While caring for a client who was admitted with myocardial infarction (MI) 2 days ago, the nurse notes today's temperature is 101.1 degrees Fahrenheit (38.5 degrees Celsius). The appropriate nursing intervention is to
- A. Call the health care provider immediately
- B. Administer acetaminophen as ordered as this is normal at this time
- C. Send blood, urine, and sputum for culture
- D. Increase the client's fluid intake
Correct Answer: B
Rationale: In this scenario, the nurse should administer acetaminophen as ordered because a slight fever is normal after an MI. This intervention can help manage the fever unless other complications are present. Calling the health care provider immediately is not necessary for a slight fever post-MI. Sending blood, urine, and sputum for culture is not indicated solely based on a slight fever without other symptoms or signs of infection. Increasing fluid intake may be beneficial for various reasons but is not the priority in this situation where managing the fever with acetaminophen is appropriate.
A client who is 2 days postoperative following abdominal surgery is transitioning from a clear liquid diet to a full liquid diet. The nurse should remind the client that which of the following items is included in a full liquid diet?
- A. Creamed peas
- B. Cottage cheese
- C. Chocolate pudding
- D. Applesauce
Correct Answer: C
Rationale: The correct answer is C, chocolate pudding. A full liquid diet consists of smooth, creamy foods like pudding. Creamed peas (choice A) are not typically allowed on a full liquid diet as they may contain solid pieces. Cottage cheese (choice B) and applesauce (choice D) are also not part of a full liquid diet as they are not in liquid form.
A healthcare professional is preparing to administer an enteral feeding via an established NG tube. Which option is not part of the sequence the healthcare professional should follow to initiate the feeding?
- A. Verify tube placement
- B. Check the residual feeding contents
- C. Administer the feeding
- D. Limit protein intake
Correct Answer: D
Rationale: The correct sequence for initiating enteral feeding includes verifying tube placement to ensure safety, checking the residual feeding contents to prevent complications, and then administering the feeding. Limiting protein intake is not a step in the sequence for initiating enteral feeding. Protein intake may be adjusted based on the patient's specific nutritional needs, but it is not a part of the immediate sequence for initiating the feeding. Therefore, option D is the correct answer. Options A, B, and C are essential steps to ensure the safe and effective administration of enteral feeding.
The school nurse is teaching the faculty the most effective methods to prevent the spread of lice in the school. The information that would be most important to include would be which of these statements?
- A. The treatment requires reapplication in 8 to 10 days.
- B. Bedding and clothing can be boiled or steamed.
- C. Children are not to share hats, scarves, and combs.
- D. Nit combs are necessary to comb out nits.
Correct Answer: C
Rationale: The most crucial information to prevent the spread of lice in schools is to avoid sharing hats, scarves, and combs. This is important as lice can easily spread through shared personal items. Choices A, B, and D are not as critical as choice C in preventing the spread of lice. Reapplication of treatment, boiling or steaming bedding and clothing, and using nit combs are important but not as crucial as avoiding the sharing of personal items.