Nokea
A nurse is providing discharge teaching to a client who is postoperative following the surgical repair of a detached retina. Which of the following statements by the client indicates an understanding of the teaching?
- A. I can go jogging after 2 weeks.â€
- B. I should bend at the waist when putting on my shoes.â€
- C. I can lift objects that are less than 10 pounds.
- D. I can resume activities: such sewing.â€
Correct Answer: D
Rationale: The correct answer is D: "I can resume activities such as sewing." This indicates an understanding of the teaching because it shows the client recognizes the need to avoid strenuous activities that may increase intraocular pressure, thus risking damage to the repaired retina. Sewing is a low-impact activity that does not involve heavy lifting or sudden movements, making it safe for the client postoperatively.
Choice A is incorrect because jogging is a high-impact activity that should be avoided for several weeks post-surgery. Choice B is incorrect because bending at the waist can increase intraocular pressure, which is not recommended post-detached retina repair. Choice C is incorrect as lifting objects, even if less than 10 pounds, can also increase intraocular pressure.
You may also like to solve these questions
Which of the following dysrhythmias is the client displaying?
- A. First-degree atrioventricular block
- B. Complete heart block
- C. Premature atrial complexes
- D. Atrial fibrillation
Correct Answer: A
Rationale: The correct answer is A: First-degree atrioventricular block. This dysrhythmia is characterized by a delay in conduction at the atrioventricular node, causing a prolonged PR interval (>0.20 sec) on ECG. It is a benign condition and does not typically require treatment unless symptomatic. Choices B and D are more serious dysrhythmias that have different ECG patterns and clinical implications. Complete heart block (Choice B) presents with a lack of conduction between the atria and ventricles, leading to a slow ventricular rate. Atrial fibrillation (Choice D) is characterized by rapid, irregular atrial depolarizations without effective atrial contractions. Premature atrial complexes (Choice C) are early ectopic atrial beats that appear as abnormal P waves on ECG but do not cause significant conduction delays.
A nurse is assessing a client who is taking haloperidol and is experiencing pseudo parkinsonism. Which of the following findings should the nurse document as a manifestation of pseudo parkinsonism?
- A. Serpentine limb movement
- B. Shuffling gait
- C. Nonreactive pupils
- D. Smacking lips
Correct Answer: B
Rationale: The correct answer is B: Shuffling gait. Pseudo parkinsonism is a common side effect of antipsychotic medications like haloperidol. A shuffling gait is a characteristic manifestation, which includes slow, shuffling, and stiff movements resembling those seen in Parkinson's disease. This occurs due to the blockade of dopamine receptors in the brain.
Choice A, serpentine limb movement, is not a typical manifestation of pseudo parkinsonism. Choice C, nonreactive pupils, is more indicative of a possible neurological issue. Choice D, smacking lips, is a manifestation of tardive dyskinesia, not pseudo parkinsonism.
The nurse notes that sediment is present in the urine.
- A. Which of the following actions should the nurse take to obtain a sterile urine specimen?
- B. Disconnect the catheter from the collection tubing.
- C. Obtain the specimen from the retention port.
- D. Use the balloon port to obtain the sterile specimen.
- E. Unclamp the collection port below the bag
Correct Answer: B
Rationale: Retention ports allow sterile specimen collection.
Which of the following statements by the client indicate an understanding of the discharge teaching? Select all that apply.
- A. I will eat small, frequent meals.
- B. I should expect my bowel movements to be pale in color.
- C. I will limit my morning coffee to no more than two cups.
- D. I will notify my provider if my urine is dark.
- E. I will eat fish for dinner at least twice per week.
Correct Answer: A,D,E
Rationale: The correct statements (A, D, E) demonstrate an understanding of discharge teaching. A shows awareness of dietary recommendations post-discharge. D indicates knowledge of abnormal urine color as a reason to notify the provider. E reflects comprehension of incorporating fish in the diet for health benefits. The incorrect choices (B, C) suggest misconceptions. B is inaccurate as pale bowel movements may indicate a liver issue. C may be harmful as coffee can interfere with medication.
A nurse is providing discharge teaching to the partner of a client who has a tracheostomy. Which of the following information should the nurse include in the teaching?
- A. How to operate the portable suction machine
- B. How to secure the tracheostomy tube with ties at the back of the neck
- C. How to change the nondisposable tracheostomy tube daily
- D. How to change the tracheostomy dressing using clean technique
Correct Answer:
Rationale: Correct Answer: B. How to secure the tracheostomy tube with ties at the back of the neck.
Rationale: Securing the tracheostomy tube with ties is crucial to prevent accidental dislodgement and ensure proper placement for oxygenation. This step helps maintain the airway and prevents complications. Teaching this ensures safety and proper care for the client.
Incorrect Choices:
A: Operating the portable suction machine is important but not the priority for discharge teaching.
C: Changing the nondisposable tracheostomy tube daily is not recommended as it can increase the risk of infection.
D: Changing the tracheostomy dressing using clean technique is essential, but securing the tube takes precedence in discharge teaching.