Nokea
A 46-year-old African-American man is in an outpatient clinic for a physical examination. His BP is 126/84 mm Hg, his BMI is 24, and he reports no previous medical problems. Which of the following actions should the nurse take?
- A. Schedule his next appointment for 1 year from now.
- B. Provide information about how to reduce risk factors of hypertension.
- C. Schedule an appointment for a prostate-specific antigen (PSA) test.
- D. Provide information for a weight loss plan that includes increasing physical activity.
Correct Answer: B
Rationale: The correct answer is B: Provide information about how to reduce risk factors of hypertension. This is the appropriate action because the patient, being African-American, is at increased risk for hypertension. Providing information on lifestyle modifications such as a healthy diet, regular exercise, and stress management can help prevent the development of hypertension. This proactive approach aligns with preventative care and promotes the patient's overall well-being.
Choice A is incorrect because annual appointments may not address potential risk factors for hypertension. Choice C, scheduling a PSA test, is not relevant to the patient's current health assessment. Choice D, providing a weight loss plan, may be beneficial but not directly related to hypertension risk reduction in this scenario.
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A nurse is caring for an older adult client who has constipation. Which of the following actions should the nurse take?
- A. Request that the provider prescribe a stool softener.
- B. Promote active range-of-motion activities.
- C. Add fluid and fiber to the diet.
- D. Avoid gas-producing foods.
Correct Answer: C
Rationale: The correct answer is C: Add fluid and fiber to the diet. Increasing fluid intake helps soften the stool, making it easier to pass. Fiber adds bulk to the stool, promoting regular bowel movements. This is a non-invasive and effective intervention for constipation in older adults. Requesting a stool softener (A) may be considered if dietary interventions are ineffective. Promoting active range-of-motion activities (B) may help prevent constipation but is not the first-line intervention. Avoiding gas-producing foods (D) is not directly related to treating constipation.
A nurse is caring for a client who has not voided for 8 hr following surgery. Which of the following actions should the nurse take first?
- A. Offer the client fluids.
- B. Perform a bladder scan.
- C. Insert an indwelling urinary catheter.
- D. Provide assistance to bathroom.
Correct Answer: B
Rationale: The correct answer is B: Perform a bladder scan. This is the first action the nurse should take because it provides valuable information about the client's bladder status without invasive intervention. The bladder scan will help determine if the client has urinary retention, which could be the reason for not voiding after surgery. Offering fluids (choice A) is important but should come after assessing the bladder. Inserting a urinary catheter (choice C) is invasive and should only be done if necessary. Providing assistance to the bathroom (choice D) is not appropriate if there is a possibility of urinary retention.
A nurse is caring for a client who has pneumonia. The client's oxygen saturation is 85%. Which of the following actions should the nurse take first?
- A. Increase the client's oral fluid intake.
- B. Initiate humidification therapy.
- C. Encourage the client to cough and deep breathe.
- D. Raise the head of the bed.
Correct Answer: D
Rationale: The correct action is to raise the head of the bed (Choice D) first. This helps improve ventilation and oxygenation by optimizing lung expansion and reducing the work of breathing. Elevating the head of the bed promotes better oxygen exchange in pneumonia patients. Increasing oral fluid intake (Choice A) may be beneficial but not the priority in this scenario. Humidification therapy (Choice B) may help with secretions but does not directly address the oxygenation concern. Encouraging cough and deep breathing (Choice C) is important for lung hygiene but should come after ensuring adequate oxygenation.
A nurse is caring for a client who is 2 days postoperative following a right hemicolectomy. When the nurse enters the client's room, he states that, following a bout of coughing, 'something popped in my belly.' The nurse lifts the sheets and sees that the client's gown is bloody. After sending a coworker to get the charge nurse and call the surgeon, which of the following actions should the nurse take next?
- A. Position the client supine with his hips and knees bent.
- B. Prepare to administer an IV infusion of 0.9% sodium chloride.
- C. Cover the wound with moist sterile gauze.
- D. Measure the client's vital signs.
Correct Answer: C
Rationale: Evisceration requires immediate covering of the wound with a sterile, moist dressing to prevent infection and tissue damage.
A nurse is instructing a client about postural drainage. The nurse should have the client lie on his stomach with his head lower than his feet to mobilize secretions from which of the following lung segments?
- A. Apical segments
- B. Both upper lobes
- C. Anterior segments of both lower lobes
- D. Posterior segments of both lower lobes
Correct Answer: D
Rationale: Prone Trendelenburg position aids in secretion clearance from posterior lung segments.