Nokea
A nurse is caring for a 37-year-old woman with metastatic ovarian cancer admitted for nausea and vomiting. The physician orders total parenteral nutrition (TPN), a nutritional consult, and diet recall. Which of the following is the BEST indication that the patient’s nutritional status has improved after 4 days?
- A. The patient eats most of the food served to her.
- B. The patient has gained 1 pound since admission.
- C. The patient’s albumin level is 4.0 mg/dL.
- D. The patient’s hemoglobin is 8.5 g/dL.
Correct Answer: C
Rationale: albumin levels are best indicators of long-term nutritional status
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The '5 A's' of smoking cessation intervention begin with which of the following?
- A. Advise all clients who smoke to stop smoking.
- B. Ask all clients about tobacco use at every visit.
- C. Assess clients' willingness to stop smoking.
- D. Assist the client to stop smoking.
Correct Answer: B
Rationale: The 5 A's begin with Ask (B), identifying tobacco use at every visit, followed by Advise, Assess, Assist, and Arrange.
A client with preeclampsia has been receiving an infusion containing magnesium sulfate for a blood pressure that is 160/80; deep tendon reflexes are 1 plus, and the urinary output for the past hour is 100 mL. The nurse should:
- A. Continue the infusion of magnesium sulfate while monitoring the client's blood pressure
- B. Stop the infusion of magnesium sulfate and contact the physician
- C. Slow the infusion rate and turn the client on her left side
- D. Administer calcium gluconate IV push and continue to monitor the blood pressure
Correct Answer: A
Rationale: The parameters (BP 160/80, 1+ reflexes, 100 mL urine output) are within acceptable limits, so the infusion should continue.
Which statement by the client regarding sickle cell disease indicates a need for further teaching?
- A. I should avoid strenuous exercise.
- B. I can enjoy one glass of red wine per day.
- C. I will avoid cigarettes and all tobacco products.
- D. I should avoid traveling to places at high altitudes such as Denver.
Correct Answer: B
Rationale: Alcohol, including red wine, can cause dehydration and increase the risk of sickle cell crisis, so it should be avoided. Other statements are correct.
A nursing instructor demonstrates to several students how to wrap an amputated limb in a bandage using a figure eight technique. Which of the following correctly states the benefits of this technique? Select all that apply.
- A. prevents blood clots from forming
- B. reduces post-operative swelling
- C. minimizes pain and discomfort
- D. prevents exposure to air
Correct Answer: B,C
Rationale: The figure-eight technique reduces swelling (B) by promoting venous return and minimizes pain (C) by stabilizing the limb. It does not prevent clots (A) or air exposure (D).
The nurse is assessing the client recently returned from surgery. The nurse is aware that the best way to assess pain is to:
- A. Take the blood pressure, pulse, and temperature
- B. Ask the client to rate his pain on a scale of 0-5
- C. Watch the client's facial expression
- D. Ask the client if he is in pain
Correct Answer: B
Rationale: A pain scale provides a reliable, subjective measure of pain.