Nokea
A client with a history of type 2 diabetes is prescribed metformin (Glucophage). The nurse should instruct the client to:
- A. Take the medication with meals.
- B. Avoid alcohol consumption.
- C. Take the medication at bedtime.
- D. Stop the medication if nausea occurs.
Correct Answer: A, B
Rationale: Metformin should be taken with meals to reduce gastrointestinal upset, and alcohol should be avoided to prevent lactic acidosis.
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The nurse is teaching a client with gastroesophageal reflux disease (GERD) about lifestyle modifications. Which recommendation is appropriate?
- A. Eat large meals to reduce acid production
- B. Sleep flat to promote digestion
- C. Avoid lying down for 2 hours after eating
- D. Drink coffee to relax the esophagus
Correct Answer: C
Rationale: Avoiding lying down for 2 hours after eating prevents acid reflux by allowing gravity to keep stomach contents in place.
A primigravid client at 26 weeks' gestation asks the nurse what causes heartburn during pregnancy. The nurse should explain to the client that heartburn during pregnancy is usually caused by which of the following?
- A. Increased peristaltic action during pregnancy.
- B. Displacement of the stomach by the diaphragm.
- C. Decreased secretion of hydrochloric acid.
- D. Backflow of stomach contents into the esophagus.
Correct Answer: D
Rationale: Heartburn is caused when stomach contents enter the distal end of the esophagus, producing a burning sensation. To avoid heartburn during pregnancy, the client should avoid spicy foods; eat smaller, more frequent meals; and avoid lying down after eating. Peristalsis usually decreases during the latter half of pregnancy. Displacement of the stomach by the uterus, not the diaphragm, may contribute to heartburn. Increased, not decreased, secretion of hydrochloric acid can exacerbate heartburn.
The current focus of performance improvement activities is to facilitate and address:
- A. Sound structures like policies and procedures
- B. Processes and how they are being done
- C. Optimal client outcomes
- D. Optimal staff performance
Correct Answer: C
Rationale: Performance improvement activities focus on achieving optimal client outcomes by improving the quality and safety of care delivery.
A nurse notices that a newborn has a swelling in the scrotum. The nurse should interpret this as indicative of hydrocele if which of the following occurs?
- A. The swollen bulge can be reduced.
- B. The increase in scrotal size is bilateral.
- C. The scrotal sac can be transilluminated.
- D. The bulge appears during crying.
Correct Answer: C
Rationale: Transillumination of the scrotal sac indicates fluid, characteristic of a hydrocele, a common newborn condition.
A client has nephrotic syndrome. To aid in the resolution of the client's edema, the physician orders 25% albumin. In addition to an absence of edema, the nurse should evaluate the client for which expected outcome?
- A. Crackles in the lung bases.
- B. Blood pressure elevation.
- C. Cerebral edema.
- D. Cool skin temperature in lower extremities.
Correct Answer: B
Rationale: Albumin increases oncotic pressure, pulling fluid into the vascular space, which may elevate blood pressure. Crackles, cerebral edema, or cool extremities would indicate complications.