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A client with cirrhosis has developed signs of heptorenal syndrome. Which diet is most appropriate for the client at this time?
- A. High protein, moderate sodium
- B. High carbohydrate, moderate sodium
- C. Low protein, low sodium
- D. Low carbohydrate, high protein
Correct Answer: C
Rationale: Low protein and low sodium diets reduce the burden on the liver and kidneys in hepatorenal syndrome.
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The client with a cervical fracture is placed in traction. Which type of traction will be utilized at the time of discharge?
- A. Russell's traction
- B. Buck's traction
- C. Halo traction
- D. Crutchfield tong traction
Correct Answer: C
Rationale: Halo traction is used for cervical fractures and can be maintained post-discharge for stabilization.
The nurse is seeing a client in the clinic who has shingles (herpes zoster). The client is concerned about spreading the disease to others. How should the nurse respond?
- A. It is only possible to have one episode of the disease.
- B. Persons with leukemia are at higher risk.
- C. Persons of all ages should receive the zoster vaccine (Zostavax).
- D. Persons between 30 and 40 years old are at high risk.
Correct Answer: B
Rationale: Shingles is contagious to immunocompromised individuals, such as those with leukemia, via contact with active lesions. The vaccine is recommended for older adults, not all ages, and recurrence is possible.
A client with acute leukemia develops a low white blood cell count. In addition to the institution of isolation, the nurse should:
- A. Request that foods be served with disposable utensils
- B. Ask the client to wear a mask when visitors are present
- C. Prep IV sites with mild soap and water and alcohol
- D. Provide foods in sealed, single-serving packages
Correct Answer: D
Rationale: Sealed, single-serving foods reduce infection risk in neutropenic patients.
During the assessment of a laboring client, the nurse notes that the FHT are loudest in the upper-right quadrant. The infant is most likely in which position?
- A. Right breech presentation
- B. Right occipital anterior presentation
- C. Left sacral anterior presentation
- D. Left occipital transverse presentation
Correct Answer: A
Rationale: Fetal heart tones loudest in the upper-right quadrant suggest a breech presentation, with the fetus's heart higher in the uterus.
The complete blood count of a client admitted with anemia reveals that the red blood cells are hypochromic and microcytic. The nurse recognizes that the client has:
- A. Aplastic anemia
- B. Iron-deficiency anemia
- C. Pernicious anemia
- D. Hemolytic anemia
Correct Answer: B
Rationale: Hypochromic, microcytic red blood cells are characteristic of iron-deficiency anemia, caused by insufficient iron for hemoglobin synthesis.