Nokea
A client who is acutely ill has vigilant oral care included in their plan of care. What factor increases this client's risk for dental caries?
- A. Hormonal changes induced by the stress response leading to an acidic oral environment
- B. Systemic infections commonly affecting the teeth
- C. Intravenous hydration lacking fluoride
- D. Inadequate nutrition and reduced saliva production contributing to cavities
Correct Answer: D
Rationale: The correct answer is D because inadequate nutrition and reduced saliva production contribute to cavities. In acute illness, the client may not be able to consume a balanced diet, leading to nutrient deficiencies that weaken teeth. Reduced saliva flow decreases the mouth's ability to naturally clean and protect teeth. Choices A, B, and C are incorrect because hormonal changes from stress do not directly lead to acidic oral environment, systemic infections do not commonly affect teeth, and lack of fluoride from intravenous hydration is not a primary factor for dental caries.
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A client with a cold is taking the antitussive benzonatate (Tessalon). Which assessment data indicates to the nurse that the medication is effective?
- A. Reports reduced nasal discharge.
- B. Denies having coughing spells.
- C. Able to sleep through the night.
- D. Expectorating bronchial secretions.
Correct Answer: B
Rationale: The correct answer is B: Denies having coughing spells. Benzonatate is an antitussive medication that suppresses cough reflex. If the client denies having coughing spells, it indicates that the medication is effectively suppressing the cough. This is the most direct indicator of the medication's effectiveness.
A: Reports reduced nasal discharge - This is not directly related to the effectiveness of benzonatate in suppressing cough.
C: Able to sleep through the night - While improved sleep may result from reduced coughing, it is not as specific an indicator of antitussive effectiveness as denying coughing spells.
D: Expectorating bronchial secretions - This indicates productive coughing, which is not the intended effect of benzonatate.
A 28-year-old woman presents with abdominal pain, bloating, and diarrhea. She notes that her symptoms improve with fasting. She has a history of iron deficiency anemia. What is the most likely diagnosis?
- A. Irritable bowel syndrome
- B. Celiac disease
- C. Lactose intolerance
- D. Crohn's disease
Correct Answer: B
Rationale: The most likely diagnosis is Celiac disease (Choice B) due to the patient's symptoms of abdominal pain, bloating, diarrhea, and improvement with fasting, which are consistent with malabsorption seen in Celiac disease. The history of iron deficiency anemia also supports this, as it is a common complication of Celiac disease due to impaired absorption of nutrients. Irritable bowel syndrome (Choice A) typically does not improve with fasting, lactose intolerance (Choice C) does not usually cause iron deficiency anemia, and Crohn's disease (Choice D) typically presents with more severe symptoms and different patterns of improvement.
A client with a history of atrial fibrillation is prescribed dabigatran (Pradaxa). Which instruction should the nurse include in the client's teaching?
- A. Take the medication with food to improve absorption.
- B. Avoid foods high in vitamin K.
- C. Take the medication at the same time each day.
- D. Increase your intake of high-potassium foods.
Correct Answer: C
Rationale: The correct answer is C: Take the medication at the same time each day. This instruction is crucial for maintaining consistent blood levels of dabigatran, maximizing its effectiveness in preventing blood clots. Taking it at the same time each day helps establish a routine and reduces the risk of missed doses.
Choice A is incorrect because dabigatran should be taken without regard to meals. Choice B is incorrect as vitamin K does not interact with dabigatran. Choice D is incorrect because increasing high-potassium foods is not necessary for dabigatran therapy.
A client with a history of chronic alcohol abuse is at risk for which of the following conditions?
- A. Liver cirrhosis
- B. Renal failure
- C. Chronic obstructive pulmonary disease (COPD)
- D. Peptic ulcer disease
Correct Answer: A
Rationale: The correct answer is A: Liver cirrhosis. Chronic alcohol abuse is a leading cause of liver cirrhosis due to the toxic effects of alcohol on the liver over time. Alcohol metabolism leads to liver inflammation, scarring, and ultimately cirrhosis. Renal failure (B) is not directly linked to alcohol abuse but can occur in severe cases. COPD (C) is primarily caused by smoking, not alcohol abuse. Peptic ulcer disease (D) can be exacerbated by alcohol but is not directly caused by chronic alcohol abuse. Therefore, the most significant risk for a client with a history of chronic alcohol abuse is developing liver cirrhosis.
A healthcare provider is providing dietary teaching to a client with cholecystitis. Which type of diet should the healthcare provider recommend?
- A. High-fiber, low-fat diet
- B. Low-fiber, high-protein diet
- C. Low-fat, low-cholesterol diet
- D. High-protein, high-fat diet
Correct Answer: C
Rationale: The correct answer is C: Low-fat, low-cholesterol diet. For cholecystitis, which is inflammation of the gallbladder, a low-fat, low-cholesterol diet is essential to prevent exacerbation of symptoms. High-fat diets can trigger gallbladder attacks, while low-fat and low-cholesterol diets help reduce the workload on the gallbladder. High-fiber (choice A) may be too harsh on the digestive system. Low-fiber, high-protein (choice B) and high-protein, high-fat (choice D) diets can exacerbate symptoms due to the high-fat content.