Nokea
A nurse is assisting an older adult client plan an exercise regimen. Which of the following activities should the nurse encourage the client to avoid?
- A. Stretching
- B. Running
- C. Resistance training
- D. Aerobic exercises
Correct Answer: B
Rationale: The correct answer is B: Running. Older adults may have joint issues, reduced bone density, or balance problems which could be exacerbated by the high impact nature of running. Encouraging the client to avoid running can help prevent injuries. Stretching (A) helps maintain flexibility, resistance training (C) improves strength, and aerobic exercises (D) enhance cardiovascular health, all of which are beneficial for older adults.
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A nurse is reinforcing dietary teaching with a client who tells the nurse she would like to reduce her solid fat intake and increase oil intake in her diet. Which of the following instructions should the nurse include in the teaching?
- A. Replace tub margarine with stick margarine.
- B. Use safflower oil instead of butter when baking.
- C. Consume 2% or whole milk.
- D. Choose ground beef that is at least 80% lean meat.
Correct Answer: B
Rationale: The correct answer is B: Use safflower oil instead of butter when baking. Safflower oil is a healthier option than butter as it is a plant-based oil that is lower in solid fats and higher in unsaturated fats. Solid fats like butter contain more saturated fats which can raise cholesterol levels. By substituting safflower oil for butter, the client can reduce solid fat intake and increase oil intake in a heart-healthy way.
Incorrect answers:
A: Replace tub margarine with stick margarine - Both tub and stick margarine are solid fats and should be limited in the diet to reduce solid fat intake.
C: Consume 2% or whole milk - Whole milk contains more solid fats compared to low-fat or skim milk, so this would not be a good choice to reduce solid fat intake.
D: Choose ground beef that is at least 80% lean meat - While lean meats are a good choice to reduce solid fat intake, ground beef still contains saturated fats.
A nurse is performing pulmonary hygiene for a client. The nurse should place the client on his right side with pillows elevating the left side of his chest to help mobilize secretions from which of the following lung segments?
- A. Lateral segment of the left lower lobe
- B. Lateral segment of the right lower lobe
- C. Posterior segment of the left upper lobe
- D. Posterior segment of the right upper lobe
Correct Answer: C
Rationale: Elevation of specific lung areas helps drain mucus and prevent complications such as pneumonia or atelectasis.
A nurse is caring for a client who is in the early stages of hypoxia and is receiving oxygen therapy. When collecting data from this client, the nurse should expect to find which of the following early indications of hypoxia?
- A. Bradypnea
- B. Peripheral edema
- C. Cyanosis
- D. Hypertension
Correct Answer: D
Rationale: Early signs of hypoxia include tachypnea, restlessness, and hypertension due to sympathetic nervous system activation.
A nurse is reinforcing teaching with a client who has atelectasis. The nurse tells the client how to position herself to promote drainage of the apical lung segments. Which of the following statements by the client should the nurse identify as understanding of the teaching?
- A. I will sit up on the side of the bed with my legs dangling.
- B. I will turn on my left side with my legs elevated higher than my chest.
- C. I will position myself on my back with my head lower than my feet.
- D. I will lie on my abdomen with pillows under my stomach and chest.
Correct Answer: D
Rationale: Prone positioning with pillows under the chest promotes postural drainage of apical lung segments. Other positions are ineffective.
A nurse is caring for four clients. Which of the following clients should the nurse expect to experience anticipatory grief?
- A. A client who has recently given up a child for adoption
- B. A client who experiences traumatic amputation of an extremity
- C. A client whose son committed suicide
- D. A client who has a new diagnosis of metastatic liver cancer
Correct Answer: D
Rationale: Anticipatory grief occurs when an individual knows a loss is imminent, as in terminal cancer.