Nokea
A client with AIDS has impaired nutrition because of diarrhea. Which diet selection by the client would indicate a need for further teaching of foods that can worsen the diarrhea?
- A. Tossed salad
- B. Baked chicken
- C. Broiled fish
- D. Steamed rice
Correct Answer: A
Rationale: Raw vegetables in a tossed salad can exacerbate diarrhea in AIDS patients. Baked chicken, broiled fish, and steamed rice are easier to digest and less likely to worsen diarrhea.
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The rationale for inserting a French catheter every hour for the client with epidural anesthesia is:
- A. The bladder fills more rapidly because of the medication used for the epidural.
- B. Her level of consciousness is such that she is in a trancelike state.
- C. The sensation of the bladder filling is diminished or lost.
- D. She is embarrassed to ask for the bedpan that frequently.
Correct Answer: C
Rationale: Epidural anesthesia can reduce bladder sensation, necessitating frequent catheterization to prevent overdistension.
A client with COPD must have the arterial blood gas (ABG) test and asks the nurse to explain the purpose of the test. Which of the following information should the nurse include? Select all that apply.
- A. ABGs measure the levels of carbon dioxide, oxygen, and acidity in the blood.
- B. ABGs help to evaluate the effectiveness of treatment.
- C. ABGs measure the degree of anemia that has developed.
- D. ABGs can help to determine the need for supplemental oxygen.
Correct Answer: A,B,D
Rationale: ABGs measure CO2, O2, and pH (A), evaluate treatment efficacy (B), and guide oxygen therapy (D). Anemia (C) is assessed via hemoglobin, not ABGs.
The doctor has ordered a patient-controlled analgesia (PCA) pump for the client with chronic pain. The client asks the nurse if he can become overdosed with pain medication using this machine. The nurse demonstrates understanding of the PCA if she states:
- A. The machine will administer only the amount that you need to control your pain without any action from you.'
- B. The machine has a locking device that prevents overdosing.'
- C. The machine will administer one large dose every 4 hours to relieve your pain.'
- D. The machine is set to deliver medication only if you need it.'
Correct Answer: B
Rationale: The PCA pump has a lockout mechanism to prevent overdosing, ensuring safe, patient-controlled dosing.
A client with heart failure has a left ventricular ejection fraction of 38%. When educating the client about managing the condition, which of the following advice should the nurse include? Select all that apply.
- A. The client should take frequent rest periods.
- B. The client should avoid strenuous activities.
- C. The client should stop all exercises.
- D. The client should stop smoking.
- E. The client should limit alcohol intake to 2 to 3 drinks daily.
Correct Answer: A,B,D
Rationale: Rest periods (A), avoiding strenuous activities (B), and stopping smoking (D) manage heart failure. All exercise (C) is not stopped; moderate activity is encouraged. Alcohol should be minimal, not 2-3 drinks (E).
A client with metastatic cancer of the lung has just been told the prognosis by the oncologist. The nurse hears the client state, 'I don't believe the doctor; I think he has me confused with another patient.' This is an example of which of Kubler-Ross' stages of dying?
- A. Denial
- B. Anger
- C. Depression
- D. Bargaining
Correct Answer: A
Rationale: The client's statement reflects denial, a stage where patients refuse to accept a terminal diagnosis, per Kubler-Ross' model.