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A client with gastroesophageal reflux disease (GERD) is being taught about lifestyle modifications. Which of the following instructions should be included?
- A. Sleep with the head of the bed elevated.
- B. Avoid drinking fluids with meals.
- C. Eat three large meals each day.
- D. Lie down after eating.
Correct Answer: B
Rationale: The correct instruction for a client with GERD is to avoid drinking fluids with meals. This is because consuming fluids while eating can exacerbate reflux symptoms by increasing stomach distension and contributing to the reflux of stomach contents into the esophagus. Option A is incorrect as elevating the head of the bed can help prevent reflux during sleep, not while drinking fluids. Option C is incorrect as consuming three large meals a day can worsen GERD symptoms due to increased gastric distension. Option D is incorrect as lying down after eating can also worsen GERD symptoms by promoting the reflux of stomach contents into the esophagus.
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A healthcare provider is educating a client with type 2 diabetes mellitus about managing blood glucose levels. Which of the following statements by the client indicates a need for further teaching?
- A. I will monitor my blood glucose levels every morning.
- B. I will stop taking my insulin if my blood glucose level is below 200 mg/dL.
- C. I will take my insulin as prescribed, even if I am feeling well.
- D. I will eat more simple carbohydrates if my blood glucose level is low.
Correct Answer: D
Rationale: The correct answer is D because consuming more simple carbohydrates when blood glucose levels are low can cause a rapid spike in blood sugar levels, leading to potential complications. Clients with type 2 diabetes should eat complex carbohydrates or foods that help stabilize blood sugar levels when experiencing hypoglycemia. Choices A, B, and C demonstrate understanding of monitoring blood glucose levels regularly, not stopping insulin without consulting a healthcare provider, and adhering to insulin therapy even when feeling well, which are all appropriate actions for managing diabetes.
A nurse is assessing a client who has been taking haloperidol for several years. Which of the following assessment findings should the nurse recognize as a long-term side effect of this medication?
- A. Lipsmacking
- B. Agranulocytosis
- C. Clang association
- D. Alopecia
Correct Answer: A
Rationale: Lipsmacking is a common sign of tardive dyskinesia, a long-term side effect of haloperidol. Tardive dyskinesia is characterized by repetitive, involuntary, purposeless movements such as lipsmacking, tongue protrusion, and facial grimacing. Agranulocytosis (choice B) is a potential side effect of antipsychotic medications but is not specifically associated with haloperidol. Clang association (choice C) is a form of disorganized speech seen in conditions like schizophrenia but is not a side effect of haloperidol. Alopecia (choice D) refers to hair loss and is not a common long-term side effect of haloperidol.
A client has a new prescription for furosemide. Which of the following instructions should the nurse include during discharge teaching?
- A. Avoid prolonged exposure to sunlight.
- B. Take this medication with a meal.
- C. Increase your intake of potassium-rich foods.
- D. Limit your fluid intake to 1 liter per day.
Correct Answer: C
Rationale: The correct instruction for a client taking furosemide is to increase their intake of potassium-rich foods. Furosemide is a loop diuretic that can lead to potassium loss, so increasing potassium-rich foods helps prevent hypokalemia. Choice A, avoiding prolonged exposure to sunlight, is not directly related to furosemide use. Choice B, taking the medication with a meal, is not a specific requirement for furosemide administration. Choice D, limiting fluid intake to 1 liter per day, is not the correct advice as furosemide is a diuretic that often requires increased fluid intake to prevent dehydration.
A client with rheumatoid arthritis is experiencing morning stiffness. Which of the following actions should the nurse take?
- A. Encourage the client to avoid physical activity in the morning.
- B. Encourage the client to take NSAIDs before bedtime.
- C. Apply cold packs to the affected joints in the morning.
- D. Perform passive range-of-motion exercises before getting out of bed.
Correct Answer: C
Rationale: The correct action the nurse should take is to apply cold packs to the affected joints in the morning. Rheumatoid arthritis is characterized by inflammation, and applying cold packs can help reduce inflammation and stiffness in the joints. Encouraging the client to avoid physical activity in the morning (Choice A) may worsen stiffness, as movement is beneficial for joint mobility. While NSAIDs (Choice B) can help with pain and inflammation, applying cold packs directly to the affected joints is more targeted and effective. Performing passive range-of-motion exercises (Choice D) can be helpful, but applying cold packs is the priority for reducing inflammation and stiffness.
How should signs of dehydration in an elderly patient be assessed?
- A. Monitor skin turgor
- B. Check for dry mucous membranes
- C. Monitor for sunken eyes
- D. Check capillary refill
Correct Answer: A
Rationale: Corrected Rationale: Monitoring skin turgor is a reliable method to assess dehydration in elderly patients. Skin turgor refers to the skin's elasticity or the skin's ability to return to its normal position after being pinched. In dehydration, the skin loses its elasticity, becoming less flexible and slower to return to its original state. Checking for dry mucous membranes (Choice B), monitoring for sunken eyes (Choice C), and checking capillary refill (Choice D) are all relevant assessments in dehydration but are not as specific or sensitive as monitoring skin turgor. Dry mucous membranes and sunken eyes are indicators of dehydration, while capillary refill is more related to circulatory status and less specific to dehydration.