Nokea
A client with diverticulosis asks about preventing flare-ups. Which recommendation should the nurse provide?
- A. Take a daily laxative to ensure regularity.
- B. Avoid nuts and seeds in the diet.
- C. Increase intake of red meat.
- D. Limit physical activity to reduce strain.
Correct Answer: B
Rationale: Avoiding nuts and seeds may reduce the risk of diverticulitis flare-ups by preventing irritation of diverticula, though evidence is mixed. Daily laxatives are not recommended, red meat is not restricted, and limiting activity is unnecessary. CN: Health promotion and maintenance; CL: Synthesize
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A 79-year-old female client is admitted to the hospital with a diagnosis of bacterial pneumonia. While obtaining the client's health history, the nurse learns that the client has osteoarthritis, follows a vegetarian diet, and is very concerned with cleanliness. Which of the following would most like to a predisposing factor for the diagnosis of pneumonia?
- A. Age.
- B. Osteoarthritis.
- C. Vegetarian diet.
- D. Daily bathing.
Correct Answer: A
Rationale: Advanced age weakens the immune system and respiratory muscles, increasing pneumonia risk. Osteoarthritis, a vegetarian diet, and daily bathing do not directly predispose to pneumonia.
Atropine sulfate (Atropine) is contraindicated in all but which one of the following clients?
- A. A client with diabetes.
- B. A client with glaucoma.
- C. A client with urine retention.
- D. A client with bowel obstruction.
Correct Answer: A
Rationale: Atropine is contraindicated in glaucoma (increases intraocular pressure), urine retention (worsens retention), and bowel obstruction (reduces motility). It is not contraindicated in diabetes, as it has no direct effect on glucose metabolism.
A client with peripheral vascular disease has undergone a right femoral-popliteal bypass graft. The blood pressure has decreased from 124/80 to 94/62. What should the nurse assess first?
- A. IV fluid rate
- B. Pedal pulses
- C. Nasal cannula flow rate
- D. Capillary refill
Correct Answer: B
Rationale: A significant drop in blood pressure post-femoral-popliteal bypass graft suggests possible hypoperfusion or graft occlusion. Assessing pedal pulses first is critical to ensure the graft is patent and blood flow is restored to the lower extremity. Compromised pulses could indicate graft failure, requiring immediate intervention. IV fluid rate, nasal cannula flow rate, and capillary refill are secondary considerations after confirming vascular patency.
A client with acute renal failure has metabolic acidosis. The nurse expects:
- A. Sodium bicarbonate administration.
- B. Increased potassium intake.
- C. Fluid bolus.
- D. High-protein diet.
Correct Answer: A
Rationale: Sodium bicarbonate corrects metabolic acidosis in acute renal failure.
A client comes to the health clinic 3 years after undergoing a resection of the terminal ileum and tells the nurse that he has weakness, shortness of breath, and a sore tongue. Which client statement indicates a need for intervention and client teaching?
- A. I have been drinking plenty of fluids.'
- B. I have been gargling with warm salt water for my sore tongue.'
- C. I have three to four loose stools per day.'
- D. I take a vitamin B12 tablet every day.'
Correct Answer: D
Rationale: Resection of the terminal ileum impairs vitamin B12 absorption, as the ileum is the primary site for B12 uptake. The client's symptoms (weakness, shortness of breath, sore tongue) suggest B12 deficiency, likely due to inadequate absorption of oral B12 supplements. The statement about taking a B12 tablet daily indicates a need for intervention, as the client may require intramuscular B12 injections. The other statements are appropriate or expected (loose stools are common post-resection).