Nokea
A nurse teaches a client with diabetes mellitus and a body mass index of 42 who is at high risk for coronary artery disease. Which statement related to nutrition should the nurse include in this client’s teaching?
- A. The best way to lose weight is a high-protein, low-carbohydrate diet.
- B. You should balance weight loss with consuming the necessary nutrients.
- C. A nutritionist will provide you with information about your new diet.
- D. If you exercise more frequently, you won’t need to change your diet.
Correct Answer: B
Rationale: Balancing weight loss with proper nutrient intake is essential for clients with diabetes and high BMI to reduce the risk of coronary artery disease.
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The jugular venous pressure (JVP) has a predictable relationship with pulmonary artery wedge pressure (PAWP). A JVP of >12 mm Hg predicted PAWP >22 mm Hg by 88% in which of the following trials?
- A. BNP
- B. ESCAPE
- C. EVEREST
- D. EMPA REG
Correct Answer: B
Rationale: The ESCAPE trial studied the effectiveness of therapies in patients with advanced heart failure and showed that elevated JVP was correlated with high pulmonary artery wedge pressures.
All patients with clinical evidence of a PDA are at increased risk for endocarditis. As a result, patients with PDA should be considered for irreversible closure EXCEPT
- A. small, hemodynamically insignificant PDA
- B. small, hemodynamically significant PDA
- C. moderate PDA
- D. large PDA
Correct Answer: A
Rationale: Small, hemodynamically insignificant PDAs may not require closure.
Which food is most important for the nurse to encourage a male client with osteomalacia to include in his daily diet?
- A. Fortified milk and cereals
- B. Lean red meat and poultry
- C. Fresh fruits and vegetables
- D. Whole grains and legumes
Correct Answer: A
Rationale: Fortified foods rich in vitamin D and calcium are crucial for the client with osteomalacia to help in bone mineralization.
Correct statement regarding congenital rubella syndrome (CRS) is
- A. CRS with vaccine-strain of virus has not been reported
- B. Re-infections during pregnancy do not result in CRS
- C. Administration of immune globulin immediately after exposure to a case during pregnancy is effective in preventing CRS
- D. Patent ductus arteriosus is the commonest manifestation of CRS
Correct Answer: A
Rationale: CRS with the vaccine-strain of the virus has not been reported, as the vaccine strain is attenuated and does not cause congenital infection.
An older adult man recently diagnosed with chronic obstructive pulmonary disease (COPD) is admitted with shortness of breath. The nurse observes the client sitting upright and leaning over the bedside table, using accessory muscles to assist in breathing. What action should the nurse take?
- A. Assist the client to a high Fowler's position in bed
- B. Observe the client for the presence of a barrel chest
- C. Prepare to transfer the client to a critical care unit
- D. Instruct the client in pursed lip breathing techniques
Correct Answer: D
Rationale: Pursed lip breathing helps reduce dyspnea and improves oxygenation in clients with COPD.