Nokea
A widowed client who is receiving chemotherapy tells the nurse that he does not like to cook for himself. A community resource for this client is:
- A. Hospice Association.
- B. Visiting Nurses' Association (VNA).
- C. Meals on Wheels.
- D. American Association of Retired Persons (AARP).
Correct Answer: C
Rationale: Meals on Wheels provides home-delivered meals, which directly addresses the client's difficulty with cooking. Hospice is for end-of-life care, VNA focuses on nursing services, and AARP offers advocacy, not meal services.
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The nurse collecting data from the client is providing instructions regarding a new prescription for disulfiram. Which datum is important for the nurse to obtain before beginning the administration of this medication?
- A. When the last full meal was consumed
- B. When the last alcoholic drink was consumed
- C. If the client has a history of hyperthyroidism
- D. If the client has a history of diabetes insipidus
Correct Answer: B
Rationale: Disulfiram may be used as an adjunct treatment for selected clients with chronic alcoholism who want to remain in a state of enforced sobriety. Clients must abstain from alcohol intake for at least 12 hours before the initial dose of the medication is administered. Therefore, it is important for the nurse to determine when the last alcoholic drink was consumed. The medication is used with caution in clients with diabetes mellitus, hypothyroidism, epilepsy, cerebral damage, nephritis, and hepatic disease. It is also contraindicated in severe heart disease, psychosis, or hypersensitivity related to the medication.
A client with the diagnosis of leukemia is receiving chemotherapy. When the registered nurse (RN) notes that the white blood cell (WBC) count is 4000 mm^3 (4 x 10^9/L), the new nurse caring for the client is informed about the results. Which intervention identified by the new nurse indicates a need for further teaching?
- A. Restricting visitors with colds or respiratory infections
- B. Removing all live plants, flowers, and stuffed animals in the client's room
- C. Placing the client on a low-bacteria diet that excludes raw foods and vegetables
- D. Padding the side rails and removing all hazardous and sharp objects from the room
Correct Answer: D
Rationale: Padding the side rails and removing all hazardous and sharp objects from the environment would be instituted if the client is at risk for bleeding. This client is at risk for infection. When the WBC count is less than 5000 mm^3 (5 x 10^9/L), visitors should be screened for the presence of infection, and any visitors or staff with colds or respiratory infections should not be allowed in the client's room. All live plants, flowers, and stuffed animals are removed from the client's room. The client is placed on a low-bacteria diet that excludes raw fruits and vegetables.
A mother is concerned about the amount of snacking her teenage boy is doing. She is concerned that this behavior could lead to obesity. Which of the following is an appropriate percentage of the daily diet to be obtained from snacks?
- A. 10%.
- B. 25%.
- C. 40%.
- D. 50%.
Correct Answer: B
Rationale: Snacks should contribute about 25% of daily caloric intake to balance nutrition without leading to excessive weight gain.
The nurse is teaching a client about the use of a transdermal nicotine patch for smoking cessation. Which instruction is correct?
- A. Apply it to the same site daily
- B. Remove it at night
- C. Keep it on during showers
- D. Apply it to the face
Correct Answer: B
Rationale: Removing the nicotine patch at night reduces the risk of side effects like insomnia and allows a nicotine-free period.
The nurse is caring for a client who has just undergone a lumbar puncture. Which of the following interventions is most appropriate in the immediate post-procedure period?
- A. Encourage ambulation to prevent stiffness.
- B. Keep the client flat for 4-6 hours.
- C. Administer oral fluids immediately.
- D. Apply heat to the puncture site.
Correct Answer: B
Rationale: Keeping the client flat for 4-6 hours post-lumbar puncture reduces the risk of spinal headache due to cerebrospinal fluid leakage.