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A client with gastroesophageal reflux disease (GERD) reports frequent heartburn. What dietary modification should the nurse recommend?
- A. Avoid eating large meals late at night.
- B. Eat a high-fat diet to buffer stomach acid.
- C. Reduce fluid intake to prevent acid reflux.
- D. Consume spicy foods to neutralize stomach acid.
Correct Answer: A
Rationale: The correct answer is to recommend avoiding eating large meals late at night. This dietary modification can help reduce the risk of acid reflux, which can exacerbate GERD symptoms. Consuming smaller, more frequent meals is generally recommended to minimize pressure on the lower esophageal sphincter. Choice B is incorrect because a high-fat diet can worsen GERD symptoms by delaying stomach emptying. Choice C is incorrect because reducing fluid intake can lead to dehydration and will not prevent acid reflux. Choice D is incorrect because spicy foods can actually trigger or worsen acid reflux symptoms in individuals with GERD.
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The nurse is responsible for several elderly clients, including a client on bed rest with a skin tear and hematoma from a fall 2 days ago. What is the best care assignment for this client?
- A. Assign an RN to supervise a nursing assistant for skin care
- B. Assign a nursing assistant to help the client with self-care activities
- C. Delegate complete care to an unlicensed assistive personnel
- D. Supervise a nursing assistant for skin care
Correct Answer: D
Rationale: In this scenario, the best care assignment for the client with a skin tear and hematoma is to supervise a nursing assistant for skin care. This ensures proper wound care while utilizing the skills of the nursing assistant effectively. Assigning an RN to supervise the nursing assistant is appropriate as it provides the necessary expertise for wound care supervision. Delegating complete care to an unlicensed assistive personnel may not be suitable for a client with specific wound care needs. Helping the client with self-care activities may not directly address the urgent need for proper wound care in this situation.
The nurse is preparing a client who had a BKA amputation for discharge to home. Which recommendations should the nurse provide this client?
- A. All of the above
- B. Inspect the skin for redness
- C. Use a residual limb shrinker
- D. Wash the stump with soap and water
Correct Answer: A
Rationale: Proper care of the residual limb is essential in preventing complications like infection or poor healing. By choosing 'All of the above,' the nurse ensures that the client receives comprehensive care. Inspecting the skin for redness is crucial as it can help in early detection of infections. Using a residual limb shrinker helps reduce swelling and maintain proper shaping of the limb. Washing the stump with soap and water on a daily basis is important for hygiene and preventing infections. Therefore, all the recommendations (choices A, B, and C) are essential for the client's care, making choice A the correct answer. Choice D is incorrect as it does not encompass all the necessary recommendations for the client's care.
An adolescent client with meningococcal meningitis is receiving a continuous IV infusion of penicillin G. How many mL/hour should the nurse program the infusion pump to deliver?
- A. 83
- B. 85
- C. 87
- D. 90
Correct Answer: A
Rationale: The correct answer is A: 83. The pharmacy provided the infusion at 10 million units per liter, which requires a rate of 83 mL/hour. To calculate this, multiply the dosage by the volume of the IV solution and divide by the concentration of the IV solution in million units: 10 million units per liter x 8.3 L = 83 mL/hour. Choices B, C, and D are incorrect as they do not align with the calculation based on the given information.
At 42-weeks gestation, a client refuses induction and desires a natural delivery. What is the most important action for the nurse to take?
- A. Discuss alternative ways to support her birth plan.
- B. Explain the indications for induction in post-term pregnancy.
- C. Discuss the differences between labor with oxytocin and natural labor.
- D. Ask the healthcare provider to discuss the issue with the client.
Correct Answer: A
Rationale: The correct answer is to discuss alternative ways to support her birth plan. It is crucial to respect the client's autonomy and desires while ensuring their safety and well-being. Choice B is incorrect because while educating the client about the indications for induction is important, it is not the most immediate action to take in this scenario. Choice C is incorrect as it focuses on comparing labor types rather than supporting the client's birth plan. Choice D is incorrect as the nurse should first engage with the client directly before involving the healthcare provider.
A 4-year-old has been hospitalized for 24 hours with skeletal traction for treatment of a fracture of the right femur. The nurse finds that the child is now crying and the right foot is pale with the absence of a pulse. What should the nurse do first?
- A. Notify the healthcare provider
- B. Readjust the traction
- C. Administer the ordered PRN medication
- D. Reassess the foot in fifteen minutes
Correct Answer: A
Rationale: A pale foot with no pulse suggests a compromised blood supply, indicating a potential vascular emergency. The nurse's immediate priority is to notify the healthcare provider to address the situation promptly. Readjusting the traction, administering PRN medication, or waiting to reassess the foot later could lead to serious complications due to the compromised blood supply, making choices B, C, and D incorrect in this critical situation.