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A nurse is reinforcing teaching for a client who was admitted with an exacerbation of COPD. Which of the following should the nurse include in the client teaching?
- A. You should consume small, frequent meals each day.
- B. You should decrease your caloric intake by 200 calories per day.
- C. You should increase your oxygen to 5 liters per minute if you have shortness of breath.
- D. You should discontinue your prednisone when your symptoms improve.
Correct Answer: A
Rationale: Small, frequent meals reduce diaphragm pressure and breathing effort in COPD. Caloric reduction isn't advised, oxygen adjustments need orders, and prednisone requires tapering.
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A nurse is reinforcing teaching with an older adult client who is postoperative following a transurethral resection of the prostate. Which of the following statements should the nurse include in the teaching?
- A. You should take ibuprofen for discomfort.
- B. You should wait 6 weeks before resuming sexual intercourse.
- C. You may tub bathe until the catheter is removed.
- D. You may drive after 1 week.
- E. Avoid drinking water.
- F. Expect bright red urine indefinitely.
- G. Ignore bladder spasms.
Correct Answer: B
Rationale: Waiting 6 weeks allows healing; ibuprofen may increase bleeding, tub baths risk infection, and driving depends on recovery.
A nurse is reviewing the laboratory data of a client who is scheduled for a liver biopsy. Which of the following values should the nurse report to the provider?
- A. Bilirubin 1.0 mg/dL (0.3 to 1.0 mg/dL)
- B. Aspartate aminotransferase 34 units/L (0 to 34 units/L)
- C. Ammonia 55 mcg/dL (10 to 80 mcg/dL)
- D. Platelets 60,000/mm3 (150,000 to 400,000/mm3)
Correct Answer: D
Rationale: A platelet count of 60,000/mm3 is significantly below the normal range and increases the risk of bleeding during a liver biopsy, so it should be reported. The other values are within normal limits and do not pose an immediate concern.
A nurse is caring for a client who is postoperative following a right radical mastectomy. Which of the following actions should the nurse take to prevent the development of lymphedema?
- A. Keep both arms below the level of the client's heart.
- B. Limit range-of-motion exercises with the affected arm.
- C. Use the client's left arm to obtain blood samples.
- D. Obtain blood pressure readings using the client's right arm.
Correct Answer: C
Rationale: Using the unaffected (left) arm for blood samples prevents trauma to the right arm, reducing the risk of lymphedema after a radical mastectomy. The affected arm should be elevated, exercised appropriately, and avoided for procedures like blood pressure readings.
A nurse is reinforcing teaching with a client who wants to lose 0.9 kg (2 lb.) of body fat per week. The nurse knows that 0.45 kg (1 lb.) of body fat is equal to 3,500 calories. The nurse should instruct the client to reduce his daily caloric intake by how many calories? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)
Correct Answer: 1000
Rationale: Calculation: 2 lb × 3,500 cal/lb = 7,000 cal/week. 7,000 ÷ 7 days = 1,000 cal/day reduction to lose 2 lb weekly.
A nurse is monitoring a client who has diabetes mellitus and a glucose level of 384 mg/dL. Which of the following findings should the nurse identify as an indication of metabolic acidosis?
- A. Tingling of the fingers
- B. Positive Trousseau's sign
- C. Increased respiratory rate
- D. Dizziness upon standing
- E. Hypotension
- F. Muscle weakness
- G. Dry mouth
Correct Answer: C
Rationale: Increased respiratory rate (Kussmaul breathing) compensates for acidosis in diabetic ketoacidosis.