Nokea
A student nurse is caring for a client with iron deficiency anemia who is newly prescribed ferrous sulfate. Which action by the student nurse requires the supervising nurse to intervene?
- A. Encourages the client to drink extra fluids while taking ferrous sulfate
- B. Offers the client orange juice for administration of ferrous sulfate
- C. Plans to administer ferrous sulfate one hour before breakfast
- D. Prepares to administer a prescribed calcium supplement with ferrous sulfate
Correct Answer: D
Rationale: Calcium inhibits iron absorption, so administering ferrous sulfate with a calcium supplement reduces its effectiveness, requiring intervention.
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The practical nurse collaborates with the registered nurse to perform an admission assessment on a client with Alzheimer disease. Which of the following techniques are appropriate when speaking with this client? Select all that apply.
- A. Ask open-ended questions
- B. Move close to the client and speak in a loud voice
- C. Remove background noise by turning off the television
- D. Touch the client on shoulder prior to speaking
- E. Use clear and simple sentences
Correct Answer: C,D,E
Rationale: Reducing background noise (C) minimizes distractions. Touching the shoulder (D) gains attention non-verbally. Using clear, simple sentences (E) accommodates cognitive impairments in Alzheimer disease.
An infant is to be admitted with severe diarrhea. Which room assignment is best for this infant?
- A. A private room
- B. A room close to the nurse's station
- C. A room with a 2-year-old child who has a broken leg
- D. A room with another infant with severe diarrhea
Correct Answer: A
Rationale: A private room prevents transmission of infectious diarrhea to others. Proximity to the station, sharing with a non-infectious patient, or another diarrheal infant increases risks.
The nurse is caring for a client with liver cirrhosis. Which of the following assessment findings would warrant immediate follow up?
- A. Black, tarry stool
- B. Bright red-streaked stool
- C. Light gray clay-colored stool
- D. Small, dry, rocky stool
Correct Answer: A
Rationale: Black, tarry stool (melena) indicates upper gastrointestinal bleeding, a serious complication in cirrhosis due to portal hypertension or varices, requiring immediate intervention.
An adult who has hepatitis A asks the nurse why her skin is yellow. The nurse should include which information when replying?
- A. The diseased liver is not able to convert bilirubin into bile, so bilirubin pigments stay in the bloodstream and cause the skin and sclera to turn yellow.
- B. The virus that causes hepatitis A leaves a yellow pigment in the bloodstream.
- C. The affected liver cells produce more bilirubin than usual, causing the skin to turn yellow.
- D. The body is trying to get rid of fecal waste products through the skin.
Correct Answer: A
Rationale: Hepatitis A impairs liver function, reducing bilirubin conjugation and excretion, leading to its accumulation in the blood, causing jaundice. The virus does not produce pigment, nor does the liver overproduce bilirubin or excrete waste through skin.
The nurse is caring for an older client who had a cerebrovascular accident (CVA) several days ago. She is having trouble speaking. How should the nurse relate to this client?
- A. Encourage the client to speak and wait patiently while she tries
- B. Speak louder to the client
- C. Finish the client's sentences when she is having difficulty
- D. Tell the client to rest her voice for the next few days
Correct Answer: A
Rationale: Encouraging speech with patience supports recovery in aphasia post-CVA, unlike loud speech, finishing sentences, or voice rest, which hinder communication progress.