Nokea
After a cholecystectomy, the client is to follow a low-fat diet. Which of the following foods would be most appropriate to include in a low-fat diet?
- A. Cheese omelet.
- B. Peanut butter.
- C. Ham salad sandwich.
- D. Roast beef.
Correct Answer: D
Rationale: A low-fat diet minimizes gallbladder workload. Roast beef (D) is leaner compared to a cheese omelet (A), peanut butter (B), or ham salad sandwich (C), which are high in fat. Thus, roast beef is the most appropriate choice.
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Which complication should the nurse monitor for in a client with a new ileal conduit?
- A. Stoma prolapse.
- B. Urinary retention.
- C. Bladder spasms.
- D. Renal colic.
Correct Answer: A
Rationale: Stoma prolapse is a potential complication of an ileal conduit, requiring surgical correction if severe.
The surgeon orders cefazolin (Ancef) 1 g to be given I.V. at 7:30 a.m. when the client's surgery is scheduled at 8:00 a.m. What is the primary reason to start the antibiotic exactly at 7:30 a.m.?
- A. Legally the medication has to be given at the ordered time.
- B. The antibiotic is most effective in preventing infection if it is given 30 to 60 minutes before the operative incision is made.
- C. The postoperative dose of Ancef needs to be started exactly 8 hours after the preoperative dose of Ancef.
- D. The peak and titer levels are needed for antibiotic therapy.
Correct Answer: B
Rationale: Administering cefazolin 30 to 60 minutes before incision ensures optimal tissue levels to prevent surgical site infections. Timing is critical for prophylactic efficacy, not legal requirements or postoperative dosing schedules.
The nurse is teaching a client about managing osteoarthritis pain. Which non-pharmacologic intervention should be included?
- A. Apply ice packs for 30 minutes at a time.
- B. Maintain a high-protein diet.
- C. Use a heating pad on high setting.
- D. Perform gentle range-of-motion exercises.
Correct Answer: D
Rationale: Gentle range-of-motion exercises maintain joint mobility and reduce stiffness in osteoarthritis.
A client is being treated for deep vein thrombosis (DVT) in the left femoral artery. The physician has ordered 60 mg of enoxaparin (Lovenox) subcutaneously. Before administering the drug, the nurse checks the client’s laboratory results, noted below. Based on these results, the nurse should:
- A. Assess the client for bleeding.
- B. Administer the medication.
- C. Inform the physician.
- D. Withhold the dose of Lovenox.
Correct Answer: D
Rationale: Based on the laboratory fi ndings, prothrombin time and INR are at acceptable anticoagulation levels for the treatment of DVT. However, the platelets are below the acceptable level. Clients taking enoxaparin are at risk for thrombocytopenia. Because of the low platelet level, the nurse should withhold the enoxaparin, assess the client for bleeding, and then contact the physician.
The nurse is assessing a client who is receiving a transfusion of platelets. The client's blood type is A-negative, and the client is receiving O-positive platelets. Which of the following actions should the nurse take?
- A. Assess the client for fluid volume deficit
- B. Document the assessment findings
- C. Stop the transfusion
- D. Notify the primary health care provider
Correct Answer: C
Rationale: Platelets from O-positive donors can cause an Rh incompatibility reaction in an A-negative client, as Rh-positive platelets may sensitize the client. The nurse should stop the transfusion and notify the provider. Fluid volume deficit is unrelated, and documenting without stopping the transfusion is inadequate.