A male client who reports feeling chronically fatigued has a hemoglobin of 11.0 grams/dl (110mmol/L), hematocrit of 34%, and microcytic and hypochromic red blood cells (RBCs). Based on these findings, which dinner selection should the nurse suggest to the client?
- A. Cheese pasta and a lettuce and tomato salad
- B. Beef steak with steamed broccoli and orange slices
- C. Broiled white fish with a baked sweet potato
- D. Grilled shrimp and season rice with asparagus salad
Correct Answer: B
Rationale: The client's lab results indicate iron deficiency anemia. Beef steak is rich in iron, and vitamin C from orange slices enhances iron absorption, making this the best choice to address the anemia.
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The nurse is planning a hypertension-prevention program. What should be the main focus of the nurse when presenting information?
- A. Pharmacological treatment
- B. Surgical interventions available
- C. Patient education
- D. Reduction of aerobic exercise
Correct Answer: C
Rationale: The main focus of a hypertension-prevention program is patient education.
The nurse is obtaining a client's fingerstick glucose level. After gently milking the client's finger, the nurse observes that the distal tip of the finger appears reddened and engorged. What action should the nurse take?
- A. Collect the blood sample
- B. Assess radial pulse volume
- C. Apply pressure to the site
- D. Select another finger
Correct Answer: A
Rationale: The reddened and engorged appearance is due to increased blood flow, and the sample can still be collected.
A diagnosis of primary pulmonary hypertension of the newborn can be made if:
- A. Oxygen saturation in the hand is 80% and in the foot 67%
- B. A tachypnoeic baby has a saturation of 60%
- C. A baby with history of being covered in thick meconium at birth has PaO2 of 4kPa
- D. A septic baby is hypoxic in 100% oxygen
Correct Answer: A
Rationale: A significant difference in oxygen saturation between the upper and lower extremities (e.g., hand 80%, foot 67%) is indicative of persistent pulmonary hypertension of the newborn (PPHN).
The primary care pediatric nurse practitioner is performing a well child examination on a school-age child who had complete repair of a tetralogy of Fallot (TOF) defect in infancy. What is important in this child's health maintenance regime?
- A. Cardiology clearance for sports participation
- B. Restriction of physical activity to avoid pulmonary complications
- C. Sub-acute bacterial endocarditis prophylaxis precautions
- D. Teaching about management of hypercyanotic episodes
Correct Answer: A
Rationale: Children who have had TOF repair must be cleared by cardiology before participation in sports.
The mother of a toddler reports that the child's father has just had a myocardial infarction (MI). Because of this, the nurse recommends the child have a(n):
- A. Electrocardiogram
- B. Lipid profile
- C. Echocardiogram
- D. Cardiac catheterization
Correct Answer: B
Rationale: Current recommendations are for a lipid profile in children over 2 years of age who have a family history of cardiac events or high cholesterol.
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