Nokea
A client with chronic kidney disease is on a low-potassium diet. Which of the following foods should the nurse recommend?
- A. Bananas
- B. Apples
- C. Oranges
- D. Potatoes
Correct Answer: B
Rationale: Apples are low in potassium, suitable for a renal diet. Bananas, oranges, and potatoes are high in potassium and should be avoided.
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When planning a presentation on the topic of osteoporosis to a group of middle-aged women, which of the following should the nurse plan to include in the presentation?
- A. An early symptom of osteoporosis is the dowager's hump
- B. African American and Latina women are at greater risk
- C. Loss of height is an early symptom of the disease
- D. Conventional radiographs are usually used to confirm the disease
Correct Answer: C
Rationale: Loss of height is an early symptom of osteoporosis due to vertebral compression fractures. Dowager's hump is a later sign, Caucasian and Asian women are at higher risk, and bone density scans, not radiographs, confirm diagnosis.
The nurse working in a long-term care setting attended a workshop on creating a restraint-free environment for the residents. When several coworkers firmly resist changing stating that their current methods are satisfactory, which action should aid the nurse in being effective in facilitating change?
- A. Pointing out to coworkers the various mistakes that they are presently making in adhering to outdated restraint procedures
- B. Informing the nursing supervisor that current restraint policies must be changed and requesting that all staff be required to comply
- C. Writing a new restraint policy over the weekend and distributing it to coworkers for immediate implementation on Monday morning
- D. Asking coworkers to help gather data comparing the facility's restraint procedures and outcomes with those of others using revised procedures
Correct Answer: D
Rationale: To be an effective change agent, the nurse must work collaboratively with others to solve common problems. The nurse who works collaboratively with others to facilitate change has a much greater chance of success than one who unilaterally demands or implements change. By enlisting the assistance of others, there is a greater chance that they will support proposed changes in procedures. To focus on errors (perceived or real) serves only to alienate others and is not effective in promoting change. A punitive atmosphere is not effective in promoting change because it discourages people from taking risks.
A client with a history of heart failure is admitted with jugular vein distension. The nurse should include which of the following in the plan of care?
- A. Administer furosemide as prescribed.
- B. Position the client in Fowler's position.
- C. Restrict sodium intake.
- D. Encourage ambulation.
Correct Answer: A, B, C
Rationale: Furosemide, Fowler's position, and sodium restriction reduce fluid overload in heart failure.
A client being mechanically ventilated after experiencing a fat embolus is visibly anxious. Which action should the nurse take?
- A. Remain with the client and provide reassurance.
- B. Ask a family member to stay with the client at all times.
- C. Encourage the client to sleep until arterial blood gas results improve.
- D. Ask the primary health care provider to write a prescription for an antianxiety medication.
Correct Answer: A
Rationale: The nurse always speaks to the client calmly and provides reassurance to the anxious client. Family members are also stressed because of the severity of the situation; therefore, it is not beneficial to ask the family to take on the burden of remaining with the client at all times. Encouraging the client to sleep will not assist in relieving the client's anxiety. Antianxiety medications are used only if necessary and if other interventions fail to relieve the client's anxiety.
Which of the following correctly describes Medicaid?
- A. A program designed to assist ill, low-income older adults.
- B. A federal insurance program for pregnant women.
- C. A joint federal-state program for low-income persons.
- D. A program administered by health maintenance organizations.
Correct Answer: C
Rationale: Medicaid is a joint federal-state program providing healthcare coverage for low-income individuals, including children, pregnant women, and the elderly.