Nokea
A nurse is providing teaching to an obese client who has gestational diabetes and is at 25 weeks of gestation. Which of the following statements made by the client indicates a need for further teaching?
- A. This does not mean that my baby will have this disease.
- B. This means that I will have diabetes for the rest of my life.
- C. If I feel dizzy, I should drink six ounces of a non-diet soda.
- D. Being obese might be one reason why I developed diabetes.
Correct Answer: B
Rationale: The statement 'This means that I will have diabetes for the rest of my life' indicates a need for further teaching. Gestational diabetes often resolves after pregnancy, although it does indicate a higher risk for developing type 2 diabetes in the future. The other choices are correct or provide appropriate information: A) Understanding that gestational diabetes does not mean the baby will have the disease is accurate. C) Advising to drink non-diet soda if feeling dizzy is incorrect and potentially harmful due to the sugar content. D) Recognizing that obesity can be a risk factor for developing diabetes is a valid statement.
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A nurse is initiating continuous enteral feedings for a client who has a new gastrostomy tube. Which of the following actions should the nurse take?
- A. Measure the client's gastric residual every 12 hours.
- B. Obtain the client's electrolyte levels every 4 hours.
- C. Keep the client's head elevated at 15° during feedings.
- D. Flush the client's tube with 30 mL of water every 4 hours.
Correct Answer: D
Rationale: Flushing the client's tube with 30 mL of water every 4 hours is essential to maintain tube patency and prevent blockages. This action helps ensure the continuous flow of enteral feedings without obstruction. Measuring the client's gastric residual every 12 hours (Choice A) is important but not the priority when initiating enteral feedings. Obtaining the client's electrolyte levels every 4 hours (Choice B) is unnecessary and not directly related to tube feeding initiation. Keeping the client's head elevated at 15° during feedings (Choice C) is a good practice to prevent aspiration, but tube flushing is more crucial to prevent tube occlusion.
A nurse is providing teaching about food allergies to the parents of a toddler. Which of the following foods should the nurse identify as highest risk for allergies in toddlers?
- A. Eggs
- B. Milk
- C. Bananas
- D. Citrus fruits
Correct Answer: A
Rationale: The correct answer is A: Eggs. Eggs are one of the most common food allergens in toddlers and should be introduced carefully. Milk (choice B) is also a common allergen but is typically introduced earlier in a child's diet. Bananas (choice C) and citrus fruits (choice D) are less likely to cause allergic reactions compared to eggs.
A client has a small-bore jejunostomy and is receiving a continuous tube feeding with a high-viscosity formula. Which of the following actions should the nurse take to prevent the tubing from clogging?
- A. Replace the bag and tubing every 24 hours
- B. Flush the tubing with 10 mL water every 6 hours
- C. Administer the feeding by gravity drip
- D. Heat the formula prior to infusion
Correct Answer: B
Rationale: To prevent clogging when using high-viscosity formulas in a small-bore jejunostomy, the nurse should flush the tubing with 10 mL of water every 6 hours. This action helps maintain tube patency and prevent blockages. Replacing the bag and tubing every 24 hours (Choice A) is unnecessary and does not specifically address preventing clogging. Administering the feeding by gravity drip (Choice C) or heating the formula prior to infusion (Choice D) are not effective interventions for preventing tubing clogging.
A nurse is providing teaching to a client who has type 1 diabetes mellitus. Which of the following statements by the client indicates an understanding of the teaching?
- A. Albumin in my urine is an indication of normal kidney function.
- B. I will keep my HbA1c at five percent.
- C. I will have ketones in my urine if my blood glucose is maintained at 190 milligrams per deciliter.
- D. I will keep my blood glucose levels between 200 and 212 milligrams per deciliter.
Correct Answer: B
Rationale: The correct answer is B. Maintaining an HbA1c level of 5 percent indicates good long-term blood glucose control and understanding of diabetes management. Choice A is incorrect because the presence of albumin in the urine (albuminuria) is actually an indication of kidney damage in diabetes. Choice C is incorrect as ketones in the urine are a sign of inadequate insulin and can occur when blood glucose levels are high, not at a specific level like 190 mg/dL. Choice D is also incorrect as the client should aim to keep blood glucose levels within a tighter range for better control, typically between 80-130 mg/dL before meals and less than 180 mg/dL after meals.
A healthcare provider is on a med-surg unit caring for a client who follows the dietary laws of Orthodox Judaism. Which of the following menu selections should the healthcare provider recommend for this client?
- A. Fried catfish
- B. Broiled shrimp
- C. Pork sausage
- D. Grilled vegetables
Correct Answer: D
Rationale: The correct answer is D: Grilled vegetables. Orthodox Judaism restricts the consumption of certain animals, including catfish, shrimp, and pork, making choices A, B, and C inappropriate for a client following these dietary laws. Grilled vegetables are a safe and suitable option that complies with Orthodox Jewish dietary guidelines.