Nokea
A client with heart failure is being taught by a nurse on reducing daily sodium intake. What is the most important factor in determining the client's ability to learn new dietary habits?
- A. The involvement of the client in planning the change
- B. The presence of a dietitian during the teaching
- C. The use of dietary supplements
- D. The client's family support
Correct Answer: A
Rationale: The most crucial factor in the client's ability to learn new dietary habits is their involvement in planning the change. When clients actively participate in setting their dietary goals, they are more likely to commit to and adhere to the changes. This empowerment fosters a sense of ownership and responsibility, enhancing the chances of successful dietary modifications. The presence of a dietitian, use of dietary supplements, and family support, while beneficial, are not as critical as the client's active participation in planning the dietary changes.
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A client requires a 24-hour urine collection. Which statement by the client indicates an understanding of the teaching?
- A. "I had a bowel movement, but I was able to save the urine."
- B. "I have a specimen in the bathroom from about 30 minutes ago."
- C. "I flushed what I urinated at 7 a.m. and have saved all urine since."
- D. "I drink a lot, so I will fill up the bottle and complete the test quickly."
Correct Answer: C
Rationale: The correct answer is C because for a 24-hour urine collection, the first void is discarded, and all subsequent urine should be saved. Choice A is incorrect because bowel movements do not contribute to a urine collection. Choice B indicates a single specimen rather than continuous collection over 24 hours. Choice D is incorrect as it incorrectly suggests rushing the test by drinking excessively.
The healthcare provider is caring for a client with a history of hypertension. Which assessment finding would be most concerning?
- A. Blood pressure of 150/90 mmHg
- B. Irregular heart rate
- C. Shortness of breath
- D. Headache
Correct Answer: C
Rationale: Shortness of breath in a client with a history of hypertension is a critical assessment finding as it may indicate heart failure, pulmonary edema, or other severe complications. The development of shortness of breath suggests that the client's condition may be rapidly deteriorating and requires immediate medical attention. Elevated blood pressure (150/90 mmHg) is concerning but not as acute as the potential complications associated with shortness of breath. An irregular heart rate and headache can also be symptoms of hypertension, but in this scenario, shortness of breath poses a higher risk of severe cardiovascular or respiratory issues.
A nurse is caring for a client who has tuberculosis. Which of the following precautions should the nurse plan to implement when working with the client?
- A. Airborne
- B. Droplet
- C. Protective
- D. Contact
Correct Answer: A
Rationale: Tuberculosis is an infectious disease that requires airborne precautions to prevent the transmission of infectious droplets. Airborne precautions involve wearing a mask, such as an N95 respirator, to protect against inhaling infectious particles. Droplet precautions are for diseases spread through respiratory droplets larger than those in airborne transmission, such as influenza. Protective precautions are not specific to respiratory infections and are more general measures to protect patients from harm. Contact precautions are used for diseases spread by direct or indirect contact, such as MRSA or C. diff infections, not for tuberculosis.
A client who requires maximal support is being taught how to use a two-wheeled walker by a nurse. Which of the following actions by the client indicates an understanding of the teaching?
- A. The client moves the walker ahead 25.4 cm with each step
- B. The client picks up the walker with each step
- C. The client stands with elbows slightly bent while holding the walker
- D. The client stoops slightly forward when moving the walker
Correct Answer: C
Rationale: The correct answer is C. When using a two-wheeled walker, the client should stand with elbows slightly bent to maintain balance and stability. This position helps distribute weight effectively and promotes proper use of the walker. Choices A, B, and D are incorrect. Choice A does not demonstrate proper posture while using the walker. Choice B of picking up the walker with each step is not the correct technique and can lead to instability. Choice D of stooping slightly forward is also incorrect as it can affect balance and posture negatively.
When taking a history of a 3-year-old with neuroblastoma, what comment by the parents requires follow-up and is consistent with the diagnosis?
- A. The child has been listless and has lost weight.
- B. The urine is dark yellow and in small amounts.
- C. Clothes are becoming tighter across her abdomen.
- D. We notice muscle weakness and some unsteadiness.
Correct Answer: C
Rationale: The correct answer is C. Clothes becoming tighter across the abdomen is indicative of an abdominal mass, a common presentation in neuroblastoma. This symptom should be followed up on further as it aligns with the diagnosis. Choices A, B, and D are less specific to neuroblastoma. Weight loss and listlessness (Choice A) can be nonspecific symptoms, while dark yellow urine in small amounts (Choice B) may suggest dehydration or other conditions. Muscle weakness and unsteadiness (Choice D) could point towards various neurological or muscular issues but are not as directly related to neuroblastoma as the symptom described in Choice C.