Nokea
All of the following are broad categories of dietary approaches EXCEPT:
- A. Energy-focused
- B. Macronutrient-focused
- C. Reward-focused
- D. Dietary timing-focused
Correct Answer: C
Rationale: Diets calories, macros, patterns, timing rule; reward's brain, not plate. Nurses map this chronic food frame, skipping psyche.
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A nurse is providing discharge teaching to a client who recently underwent a mechanical valve replacement. Which of the following statements by the client indicates the clients correct understanding of the discharge teaching regarding warfarin anticoagulant therapy?
- A. I may need to modify my diet while on this medication
- B. I do not need to take my prescribed medication for the rest of my life
- C. Additional monitoring is not required while on the anticoagulant
- D. I can lead a normal life while on anticoagulants; no restrictions are required
Correct Answer: A
Rationale: Mechanical valves demand warfarin forever diet tweaks, like steady vitamin K, keep INR stable, a sign the client gets it. Lifelong meds, monitoring, and restrictions (e.g., bleeding risk) are non-negotiable. Nurses cheer this dietary nod, ensuring warfarin's tightrope walk succeeds, a smart grasp in this valve swap life.
A child is seen in the pediatrician's office for complaints of bone and joint pain. Which other assessment finding may indicate leukemia?
- A. Abdominal pain
- B. Increased activity level
- C. Increased appetite
- D. Petechiae
Correct Answer: D
Rationale: Leukemia often presents with bone and joint pain due to marrow infiltration by leukemic cells, but petechiae small red or purple spots from minor bleeds under the skin are a key additional sign of bleeding tendencies from thrombocytopenia, a common leukemia consequence. This reflects bone marrow failure to produce adequate platelets, making it a critical finding for nurses to note during assessment. Abdominal pain might occur from organ enlargement (e.g., splenomegaly), but it's less specific and not a primary complaint here. Increased activity level and appetite contradict leukemia's typical fatigue and anorexia due to metabolic demands of proliferating cells and anemia. Recognizing petechiae prompts urgent blood work and referral, aligning with nursing's role in early detection of pediatric leukemia, ensuring timely intervention to manage this life-threatening condition effectively.
A patient on the oncology unit is receiving carmustine, a chemotherapy agent, and the nurse is aware that a significant side effect of this medication is thrombocytopenia. Which symptom should the nurse assess for in patients at risk for thrombocytopenia?
- A. Interrupted sleep pattern
- B. Hot flashes
- C. Epistaxis (nose bleed)
- D. Increased weight
Correct Answer: C
Rationale: Carmustine, a nitrosourea, slams bone marrow, dropping platelets and causing thrombocytopenia low counts mean bleeding risks soar. Epistaxis (nosebleeds) is a classic sign, as mucosal vessels lack clotting support, especially with counts below 50,000/µL. Sleep issues might tie to discomfort but aren't direct. Hot flashes link to hormonal therapies, not this. Weight gain's unrelated cancer often causes loss. Nurses zero in on bleeding like epistaxis, bruising, or petechiae checking daily for these red flags, vital in oncology to catch and manage this life-threatening chemo fallout early.
Patients with poorly controlled type 2 diabetes often have increased fasting triglyceride levels. Question: Which explanation for these increased fasting triglyceride levels is most likely?
- A. The triglyceride production of adipose tissue is not sufficiently inhibited by insulin
- B. Increased VLDL production leads to increased levels of free fatty acids
- C. The VLDL production by the liver is not sufficiently inhibited by insulin
- D. The LDL uptake by adipose tissue is not sufficiently stimulated by insulin
Correct Answer: C
Rationale: Type 2's triglyceride rise liver VLDL pumps unchecked, insulin flops, not fat tissue or LDL games. Nurses target this, a chronic liver lipid leak.
A client in the oncology clinic reports her family is frustrated at her ongoing fatigue 4 months after radiation therapy for breast cancer. What response by the nurse is most appropriate?
- A. Are you getting adequate rest and sleep each day?
- B. It is normal to be fatigued even for years afterward.
- C. This is not normal and I'll let the provider know.
- D. Try adding more vitamins B and C to your diet.
Correct Answer: B
Rationale: Radiation therapy, commonly used for breast cancer, can cause persistent fatigue as a side effect due to cellular damage and the body's prolonged healing process. This fatigue can last for months or even years post-treatment, varying by individual factors like radiation dose and overall health. Telling the client it's normal validates her experience, reduces anxiety, and helps her family understand this as a common outcome rather than a personal failing. Asking about rest is useful but doesn't address the family's frustration or provide context. Declaring it abnormal and escalating to the provider is inaccurate unless other symptoms suggest a new issue, potentially causing unnecessary worry. Suggesting vitamins lacks evidence for resolving radiation-induced fatigue and shifts focus from education. The nurse's role here is to reassure and educate, making the normalization of long-term fatigue the most appropriate response, fostering coping and support within the family.