A nurse is caring for a client who is postop following abdominal surgery. What behavior should the nurse identify as increasing the client's risk for constipation?
- A. Increased fiber intake
- B. Decreased physical activity
- C. Frequent urge suppression
- D. Adequate sleep
Correct Answer: B
Rationale: The correct answer is B: Decreased physical activity. Following abdominal surgery, reduced physical activity can contribute to constipation due to decreased bowel motility. Increased fiber intake (choice A) generally helps prevent constipation by adding bulk to the stool. Frequent urge suppression (choice C) may lead to issues like urinary retention but is not directly linked to constipation. Adequate sleep (choice D) is important for overall recovery but does not significantly impact constipation risk.
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A healthcare professional is preparing to administer multiple medications to a client with dysphagia. What action should the healthcare professional take?
- A. Offer the medications with a full glass of water
- B. Crush the medications and mix them together
- C. Provide the medications through a straw
- D. Mix the medications with applesauce
Correct Answer: C
Rationale: Clients with dysphagia have difficulty swallowing, so providing medications through a straw can help control the flow and prevent aspiration. Offering medications with a full glass of water (Choice A) may increase the risk of aspiration. Crushing medications and mixing them together (Choice B) can alter the medication's effectiveness or cause adverse effects. Mixing medications with applesauce (Choice D) may also present a choking hazard for clients with dysphagia.
While assessing the IV infusion site of a client experiencing pain, redness, and warmth, what should the nurse do?
- A. Increase the IV flow rate
- B. Discontinue the infusion
- C. Elevate the limb
- D. Apply a cold compress
Correct Answer: B
Rationale: The correct answer is to discontinue the infusion. Pain, redness, and warmth at the IV site are signs of phlebitis, which is inflammation of the vein. Continuing the infusion can further irritate the vein and lead to complications. Increasing the IV flow rate would exacerbate the issue by delivering more irritants to the vein. Elevating the limb and applying a cold compress are not the appropriate interventions for phlebitis, as discontinuing the infusion is crucial to prevent further harm.
A nurse is assessing a client who reports pain and redness at the site of a peripheral IV. What should the nurse do first?
- A. Apply a cold compress to the site
- B. Discontinue the IV line
- C. Notify the provider
- D. Increase the IV flow rate
Correct Answer: B
Rationale: When a client reports pain and redness at the site of a peripheral IV, indicating signs of phlebitis, the nurse's initial action should be to discontinue the IV line. This helps prevent further complications and ensures patient safety. Applying a cold compress (Choice A) may provide temporary relief but does not address the underlying issue. Notifying the provider (Choice C) is important but not the initial step. Increasing the IV flow rate (Choice D) can exacerbate the inflammation and should be avoided.
A nurse in a provider's office is assessing a client who reports a decrease in the effectiveness of their arthritis medication. What factor should the nurse identify as contributing to this decrease?
- A. Increased activity level
- B. Bowel inflammation
- C. Long-term use of the medication
- D. History of dehydration
Correct Answer: B
Rationale: Bowel inflammation can reduce the absorption of oral medications, leading to decreased effectiveness. In this case, the decrease in the effectiveness of the arthritis medication could be attributed to impaired absorption due to bowel inflammation. Choices A, C, and D are incorrect because increased activity level, long-term use of the medication, and history of dehydration are not directly associated with a decrease in medication effectiveness related to absorption issues.
A client with diabetes mellitus is being taught about foot care by a nurse. Which statement indicates understanding?
- A. I will soak my feet in hot water daily
- B. I will wear my slippers whenever I am out of bed
- C. I should apply lotion between my toes after washing my feet
- D. I will cut my nails in a rounded shape
Correct Answer: B
Rationale: The correct answer is B. Wearing slippers or shoes when out of bed is crucial for clients with diabetes as it helps prevent injuries to the feet, reducing the risk of infection. Choices A, C, and D are incorrect. Soaking feet in hot water daily can lead to dryness and skin damage, applying lotion between toes can create a moist environment promoting fungal growth, and cutting nails in a rounded shape can increase the risk of ingrown nails.
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