Nokea
A clinic nurse providing home care instructions to an adolescent diagnosed with iron deficiency anemia concentrates on the administration of oral iron preparations. The nurse should tell the adolescent that it is best to take the iron with which liquid?
- A. Cola
- B. Soda
- C. Water
- D. Tomato juice
Correct Answer: D
Rationale: Iron should be administered with vitamin C-rich fluids because vitamin \mathrm{C enhances the absorption of the iron preparation. Tomato juice has a high ascorbic acid (vitamin C) content, whereas cola, soda, and water do not contain vitamin C.
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Which instruction should the nurse include in the teaching plan for a client taking iron supplements to correct iron deficiency anemia?
- A. Eat a low-fiber diet.
- B. Limit the intake of fluids.
- C. Limit the intake of meat, fish, and poultry.
- D. Avoid taking the iron supplements with milk or antacids.
Correct Answer: D
Rationale: The client should avoid taking the iron supplements with milk or antacids because these items decrease the absorption of iron. The client should also avoid taking the iron with food, if possible. Finally, the client should take in sufficient fiber and fluids to prevent constipation as a side effect of iron therapy. The client should increase the intake of natural sources of iron, such as meats, fish, and poultry.
The nurse has been preparing a client diagnosed with chronic obstructive pulmonary disease for discharge. Which statement by the client indicates the need for further teaching about nutrition?
- A. I will rest a few minutes before I eat.
- B. I will not eat as much cabbage as I once did.
- C. I will certainly try to drink 3 L of fluid every day.
- D. It's best to eat three large meals a day, so that I will get all my nutrients.
Correct Answer: D
Rationale: Large meals distend the abdomen and elevate the diaphragm, which may interfere with breathing for the client diagnosed with chronic obstructive pulmonary disease. Resting before eating may decrease the fatigue that is often associated with chronic obstructive pulmonary disease. Gas-forming foods may cause bloating, which interferes with normal diaphragmatic breathing. Adequate fluid intake helps liquefy pulmonary secretions.
The home care nurse has given instructions to a client who was recently discharged from the hospital regarding the care of an arterial ischemic leg ulcer. The nurse determines that there is a need for further teaching if the client makes which statement?
- A. I should inspect my feet daily.
- B. I should wear shoes and socks.
- C. I should cut my toenails straight across.
- D. I should raise my legs above the level of my heart periodically.
Correct Answer: D
Rationale: Raising legs above heart level is inappropriate for arterial ischemic ulcers, as it reduces blood flow to the extremities, worsening ischemia. Daily foot inspection, wearing shoes and socks, and cutting toenails straight across are correct care measures.
The nurse is working with a client who has just been diagnosed with pancreatic cancer. The client says, 'I have so much left to do. I'm too young to die like this.' Which of the following stages of Kübler-Ross's five stages of grieving does the nurse recognize in this client?
- A. anger
- B. denial
- C. bargaining
- D. acceptance
- E. depression
Correct Answer: C
Rationale: The client's statement reflects bargaining, expressing a desire to delay death to accomplish more.
The nursing student is providing care to a preschooler diagnosed with an immunocompromised condition. The nursing instructor is reviewing with the nursing student a list of potential immunizations to be administered to this client. Which immunizations should the nursing student identify as safe to administer to this client?
- A. OPV
- B. MMR
- C. DTaP
- D. Varicella
- E. Influenza
- F. Meningococcal
Correct Answer: C,E,F
Rationale: DTaP, influenza, and meningococcal immunizations are recommended for immunocompromised clients. These vaccines provide either passive immunity or the risk of complications from the potential illness outweigh the risk of the immunization. An immunocompromised individual under ordinary circumstances should not receive a live or attenuated vaccine. OPV, MMR, and varicella are all categorized as live or attenuated vaccines.