Nokea
A client who is taking an antipsychotic medication is preparing for discharge. To facilitate health promotion for this client, what instruction should the nurse provide?
- A. Avoid prolonged exposure to the sun.
- B. Adhere to a strict tyramine-restricted diet.
- C. Recognize the signs and symptoms of a relapse of depression.
- D. Have therapeutic blood levels drawn because the medication has a narrow therapeutic range.
Correct Answer: A
Rationale: Antipsychotic medications improve the thought processes and behaviors of a client with psychotic symptoms, especially a client with schizophrenia. Photosensitivity is a side effect of antipsychotic medications. Maintaining a strict tyramine-restricted diet is applicable to monoamine oxidase inhibitors (MAOIs). Antipsychotics are not used to treat depression. Lithium is a mood stabilizer that requires monitoring of medication blood levels.
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The clinic nurse instructs a client diagnosed with diabetes mellitus about preventing diabetic ketoacidosis on days when the client is feeling ill. Which statement by the client indicates the need for further teaching?
- A. I need to stop my insulin if I am vomiting.
- B. I need to call my doctor if I am ill for more than 24 hours.
- C. I need to eat 10 to 15 g of carbohydrates every 1 to 2 hours.
- D. I need to drink small quantities of fluid every 15 to 30 minutes.
Correct Answer: A
Rationale: Diabetic ketoacidosis is a life-threatening complication of type 1 diabetes mellitus that develops when a severe insulin deficiency occurs. The client needs to be instructed to continue taking insulin, even if vomiting and unable to eat, to prevent ketoacidosis. It is important to self-monitor blood glucose more frequently during illness (every 2 to 4 hours). If the premeal blood glucose is more than 250 mg/dL, the client should test for urine ketones and contact the primary health care provider. Calling the doctor if ill for more than 24 hours, consuming 10 to 15 g of carbohydrates every 1 to 2 hours, and drinking small quantities of fluid every 15 to 30 minutes are accurate interventions to maintain hydration and glucose control during illness.
A nurse is assisting a pregnant client who is having an amniocentesis. Which of the following statements by the nurse indicates the correct teaching for this procedure?
- A. I'm going to help you lie lat on your back for this."
- B. Don't worry, I'm sure everything will be all right."
- C. I will need to help you remove your shirt for this procedure."
- D. Now that the procedure is inished, I will put a small bandage over the puncture site."
Correct Answer: D
Rationale: An amniocentesis is performed to draw amniotic luid from the sac around the fetus during pregnancy. It may be analyzed for certain disorders or complications associated with pregnancy. Following the procedure, the nurse should wash the client's abdomen and place a small bandage over the puncture site
Which of the following situations might warrant a laboratory magnesium level?
- A. Hyperthyroidism
- B. Arthritis
- C. Ulcerative colitis
- D. Depression
Correct Answer: C
Rationale: Ulcerative colitis can lead to symptoms such as abdominal pain, fever, diarrhea, and weight loss. This condition may impact the absorption of certain nutrients, including magnesium. Therefore, patients with chronic gastrointestinal conditions like ulcerative colitis should be screened for electrolyte imbalances related to impaired digestion. Hyperthyroidism, arthritis, and depression do not typically directly affect magnesium levels in the same way as gastrointestinal conditions like ulcerative colitis.
The nurse is conducting a health fair at a local high school on reducing high-risk behaviors. Which teaching should the nurse include in the presentation? Select all that apply.
- A. Always buckle up, even for a short trip.
- B. Use approved bike helmets for bike riding.
- C. Do not drive for one hour after drinking alcohol.
- D. Condoms offer full protection against sexually transmitted infections.
- E. Dive into untested waters with the hands fully extended over the head.
Correct Answer: A,B
Rationale: Seat belts and helmets reduce injury risk. Waiting one hour post-alcohol is insufficient, condoms don't fully protect against all STIs, and diving into untested waters is dangerous.
A nurse is caring for an 83-year-old man who has had swallowing difficulties. All of the following interventions are appropriate for this client EXCEPT:
- A. Keep the client in an upright position at all times
- B. Auscultate lung sounds every shift and after feedings
- C. Maintain suction equipment at the client's bedside
- D. Instruct the client about how to perform swallowing exercises
Correct Answer: A
Rationale: When caring for a client with swallowing difficulties, it is crucial to prevent aspiration of food into the lungs. Appropriate interventions include auscultating lung sounds every shift and after feedings to assess for any changes in breathing patterns, maintaining suction equipment at the client's bedside in case of difficulties, and providing instruction on swallowing exercises. Keeping the client in an upright position at all times is not necessary and may not always be feasible or comfortable for the client. This rigid requirement is not part of the standard care protocol for managing swallowing difficulties.