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A nurse is collecting data from a client who has an inadequate dietary intake of fiber. Which of the following findings should the nurse expect?
- A. Constipation
- B. Memory loss
- C. Brittle hair
- D. Bleeding gums
Correct Answer: A
Rationale: Low fiber intake slows digestion, leading to constipation.
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A nurse is assisting with teaching a client who is on a soft diet. Which of the following foods should the nurse include in the teaching?
- A. Ground beef
- B. Raw vegetables
- C. Fruit with the skin
- D. High-fiber cereals
Correct Answer: A
Rationale: Ground beef is soft and easy to chew, suitable for a soft diet.
A nurse is collecting data on a client who is experiencing hypovolemia. Which of the following findings should the nurse expect?
- A. Peripheral edema
- B. Oliguria
- C. Hypertension
- D. Bradycardia
Correct Answer: B
Rationale: Oliguria occurs in hypovolemia as kidneys conserve fluid due to low volume.
A nurse is reinforcing teaching about the manifestations of hyperglycemia with a client who has diabetes mellitus. Which of the following statements by the client indicates an understanding of the teaching?
- A. My breath may have a fruity odor.
- B. I will be more thirsty than usual.
- C. My appetite will be decreased.
- D. I might experience blurry vision at times.
Correct Answer: B
Rationale: Increased thirst (polydipsia) is a classic hyperglycemia symptom due to dehydration from glucose excretion.
A nurse is preparing for a client who is at risk for a pressure injury. Which of the following actions should the nurse take?
- A. Elevate the head of the client's bed 45°
- B. Massage the client's bony prominences
- C. Provide the client with a high-calorie diet
- D. Reposition the client every 4 hrs
Correct Answer: C
Rationale: A high-calorie diet supports skin integrity and healing, reducing pressure injury risk.
A nurse is caring for a client in a long-term care facility who is receiving enteral feedings via an NG tube. Which of the following actions should the nurse take prior to administering the tube feeding?
- A. Assist the client to low Fowler's position.
- B. Test the pH of gastric aspirate.
- C. Discard any residual gastric contents.
- D. Warm the feeding solution to body temperature.
Correct Answer: B
Rationale: Testing gastric aspirate pH confirms NG tube placement in the stomach (pH 1-4).