Nokea
A client with lung cancer is advised to increase the protein and kilocalorie content of his diet. Which of the following choices will best meet his need for increased protein and calories?
- A. Toast, jelly, chicken broth
- B. Crackers, butter, fresh vegetables
- C. Crackers, fresh fruit, ginger ale
- D. Crackers, cheese, fruit yogurt
Correct Answer: D
Rationale: Cheese and yogurt provide high protein and calories, ideal for a client with lung cancer needing nutritional support.
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The nurse observes a LPN/LVN perform a wet-to-dry dressing change on a 2-inch abdominal incision.
- A. Which behavior by the LPN/LVN indicates proper wet-to-dry dressing change technique?
- B. A clean cotton ball is used to cleanse from the top of the incision to the bottom of the incision using long strokes.
- C. The incision is packed with sterile gauze, and then sterile saline is poured over the dressing.
- D. The nurse packs wet gauze into the incision without overlapping it onto the skin.
- E. The old dressing is saturated with sterile saline before it is removed.
Correct Answer: C
Rationale: Packing wet gauze into the incision without overlapping onto the skin prevents skin breakdown from prolonged moisture exposure. Cleansing should be from the center outward, dressings should be pre-soaked, and old dressings are removed dry to debride the wound.
A 5-year-old child has been treated for sickle cell crisis. The parent asks the nurse if there is anything that can be done to prevent future crises. What should be included in the nurse's response?
- A. Sickle crisis is hard to predict and not usually preventable.
- B. Keeping the child from getting chilled may prevent a crisis.
- C. Fevers, vomiting, and diarrhea should be reported to the physician immediately.
- D. Giving the child aspirin on a daily basis lessens the frequency of crises.
Correct Answer: C
Rationale: Fevers, vomiting, and diarrhea can trigger sickle cell crisis by causing dehydration or infection, so prompt reporting allows early intervention to prevent crises.
Which of the following describes the proximodistal development in the infant?
- A. The infant is able to raise his head before he is able to sit.
- B. The infant can control movements of his arms before he can control movements of his fingers.
- C. The infant responds to pain with his whole body before he can localize pain.
- D. The infant is able to make rudimentary vocalizations before using spoken words.
Correct Answer: B
Rationale: Proximodistal development refers to motor control progressing from the center of the body outward, meaning infants gain control of larger muscles (arms) before finer muscles (fingers).
In planning discharge teaching for a client after a lumbar laminectomy, the nurse would instruct the client to exercise regularly to strengthen which muscles?
- A. Anal sphincter.
- B. Abdominal.
- C. Trapezius.
- D. Rectus femoris.
Correct Answer: B
Rationale: strengthening the abdominal muscles adds support for the muscles supporting the lumbar spine
The nurse is caring for a woman who had a mastectomy following a diagnosis of breast cancer. When the nurse enters the room, the curtains are drawn, and the client is lying with her body turned toward the wall away from the nurse. When the nurse approaches her, the client says, 'Just leave me alone. I'm no use to anyone. I'm not even a real woman.' How should the nurse respond?
- A. Leave the room
- B. Open the curtains
- C. Say, 'You sound upset.'
- D. Say, 'Women are more than breasts.'
Correct Answer: C
Rationale: Acknowledging the client's feelings is an appropriate response to this common grief reaction following the loss of a body part. Leaving the room would reinforce the client's perception that she is useless. Opening the curtains does not address the client's concerns; it merely forces the nurse's perception of appropriateness on the client. Saying 'Women are more than breasts' is not an appropriate response to the client. The nurse should recognize the client's feelings, not put her down.