Nokea
A client with a diagnosis of gastroesophageal reflux disease (GERD) has just received a breakfast tray. The nurse notices that which is the only food that will increase the lower esophageal sphincter (LES) pressure and thus lessen the client's symptoms?
- A. Coffee
- B. Nonfat milk
- C. Fresh scrambled eggs
- D. Whole wheat toast with butter
Correct Answer: B
Rationale: Foods that increase the LES pressure will decrease reflux and lessen the symptoms of GERD. The food substance that will increase the LES pressure is nonfat milk. The other substances listed decrease the LES pressure, thus increasing reflux symptoms. Aggravating substances include chocolate, coffee, fatty foods, and alcohol and should be avoided in the diet of a client with GERD.
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The nurse is caring for a client with a history of atrial fibrillation who is prescribed amiodarone (Cordarone). Which of the following side effects should the nurse monitor for?
- A. Pulmonary toxicity.
- B. Hyperglycemia.
- C. Weight gain.
- D. Hair loss.
Correct Answer: A
Rationale: Amiodarone can cause pulmonary toxicity, a serious side effect requiring regular monitoring of lung function.
The membranes of a multigravid client in active labor rupture spontaneously, revealing greenish colored amniotic fluid. The nurse interprets this finding as related to which of the following?
- A. Passage of meconium by the fetus.
- B. Maternal intrauterine infection.
- C. Rh incompatibility between mother and fetus.
- D. Maternal sexually transmitted disease.
Correct Answer: A
Rationale: Greenish amniotic fluid indicates meconium passage, often due to fetal stress.
The nurse is assessing a client who has had a myocardial infarction. The nurse notes the cardiac rhythm shown below. The nurse identifies that this rhythm is:
- A. Atrial fi brillation
- B. Ventricular tachycardia
- C. Premature ventricular contractions.
- D. Third-degree heart block.
Correct Answer: D
Rationale: Third-degree heart block occurs when atrial stimuli are blocked at the atrioventricular junction. Impulses from the atria and ventricles are conducted independently of each other. The atrial rate is 60 to 100 bpm; the ventricular rate is usually 10 to 60 bpm.
A client with heart failure is prescribed furosemide (Lasix). Which assessment finding indicates the medication is effective?
- A. Increased blood pressure.
- B. Decreased edema.
- C. Weight gain.
- D. Elevated potassium levels.
Correct Answer: B
Rationale: Furosemide is a diuretic that reduces fluid overload, so decreased edema indicates effective treatment by promoting fluid excretion.
Select the sound that is heard with percussion with its description.
- A. Tympany: A hollow sound
- B. Dullness: A thud like sound
- C. Dullness: A hollow sound
- D. Resonance: A booming sound
Correct Answer: A,B,D
Rationale: Tympany is a hollow sound (e.g., over air-filled structures like the stomach), dullness is a thud-like sound (e.g., over solid organs like the liver), and resonance is a booming sound (e.g., over lung tissue). Option C is incorrect because dullness is not a hollow sound.