Nokea
A client with Parkinson's disease complains of 'choking' when he swallows. Which intervention will improve the client's ability to swallow?
- A. Withholding liquids until after meals
- B. Providing semi-liquids when possible
- C. Providing a full liquid diet
- D. Offering small, more frequent meals
Correct Answer: B
Rationale: Semi-liquids are easier to swallow for Parkinson's patients with dysphagia. Withholding liquids risks dehydration. Full liquid diets may be too thin. Small meals help nutrition but not swallowing.
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The nurse is caring for a client with a venous stasis ulcer. Which nursing intervention would be most effective in promoting healing?
- A. Apply dressing using sterile technique
- B. Improve the client's nutrition status
- C. Initiate limb elevation and compression
- D. Begin proteolytic debridement
Correct Answer: B
Rationale: The goal of clinical management in a client with venous stasis ulcers is to promote healing. This only can be accomplished with proper nutrition. The other interventions are appropriate, but without proper nutrition, they would be of little help.
A client comes to the emergency department for the second time with shortness of breath and substernal pressure that radiates to the jaw. The nurse understands that angina pectoris may be precipitated by which of these factors? Select all that apply.
- A. Amphetamine use
- B. Cigarette smoking
- C. Cold exposure
- D. Deep sleep
- E. Sexual intercourse
Correct Answer: A,B,C,E
Rationale: Angina can be triggered by amphetamines increasing cardiac demand, smoking causing vasoconstriction, cold exposure inducing vasospasm, and sexual intercourse raising heart rate. Deep sleep typically reduces demand.
The licensed practical nurse (LPN) is assisting the registered nurse in caring for 4 clients. Which client is at greatest risk for the development of deep venous thrombosis?
- A. 25-year-old client with abdominal pain who smokes cigarettes and takes oral contraceptives
- B. 55-year-old ambulatory client with exacerbation of chronic bronchitis and an elevated hematocrit level
- C. 72-year-old client who had coronary stent placement 2 days ago and has an elevated temperature
- D. 80-year-old client who had surgical repair of a fractured hip 4 days ago
Correct Answer: D
Rationale: An 80-year-old post-hip surgery client is at highest DVT risk due to age, immobility, and recent surgery. Smoking and contraceptives , elevated hematocrit , and stent with fever carry risks but are less immediate.
The nurse observes a nursing assistant caring for an 86-year-old woman who had an open reduction/internal fixation for a fractured femur two days ago. Which action by the nursing assistant needs correction by the nurse?
- A. The nursing assistant places an abductor pillow between the client's legs while turning the client.
- B. The nursing assistant asks the client to put full weight on both legs while using the walker.
- C. The nursing assistant has a high extended bedside commode available for the client.
- D. The nursing assistant encourages the client to bathe herself.
Correct Answer: B
Rationale: Full weight-bearing two days post-femur fixation is inappropriate, risking hardware failure; partial or non-weight-bearing is typical. Abductor pillows, commodes, and self-bathing are appropriate.
The nurse is caring for an adult who is receiving diphenoxylate hydrochloride with atropine sulfate (Lomotil) qid. What nursing assessment is essential while the client is receiving this medication?
- A. Monitor blood pressure hourly
- B. Assess respirations before administering drug
- C. Measure hourly urine output
- D. Do neuro checks every two hours
Correct Answer: B
Rationale: Lomotil can cause respiratory depression due to its opioid component, requiring respiratory assessment before administration.