Nokea
An adult who is on an American Dietetic Association (ADA) diabetic diet tells the nurse that she will not eat the asparagus that is on her tray. What would be an appropriate substitute for the nurse to offer?
- A. Broccoli
- B. Corn
- C. Peas
- D. Beets
Correct Answer: A
Rationale: Broccoli, like asparagus, is a non-starchy vegetable, fitting the ADA diabetic diet's emphasis on low-glycemic foods. Corn, peas, and beets are higher in carbohydrates.
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The nurse is performing an admission history for a client recovering from a stroke. Medication history reveals the drug clopidogrel (Plavix). Which clinical manifestation alerts the nurse to an adverse effect of this drug?
- A. Epistaxis
- B. Abdominal distention
- C. Nausea
- D. Hyperactivity
Correct Answer: A
Rationale: Clopidogrel is an antiplatelet medication that can increase the risk of bleeding, such as epistaxis (nosebleeds). Abdominal distention, nausea, and hyperactivity are not typical adverse effects of clopidogrel, so answers B, C, and D are incorrect.
The initial response by the nurse to a delusional client who refuses to eat because of a belief that the food is poisoned is
- A. You think that someone wants to poison you?
- B. Why do you think the food is poisoned?
- C. These feelings are a symptom of your illness.
- D. You're safe here. I won't let anyone poison you.
Correct Answer: A
Rationale: You think that someone wants to poison you? This acknowledges the client's perception, opening discussion and expressing doubt.
A client who is diagnosed with cystitis has been given a prescription for phenazopyridine (Pyridium). She asks the nurse why she has been given this medication. What should the nurse reply?
- A. Pyridium is an antibiotic that will kill the bacteria causing your infection.'
- B. Pyridium is an analgesic that will make you less aware of the pain and discomfort.'
- C. Pyridium is a urinary tract anesthetic that will kill the pain until the antibiotics have had time to work.'
- D. Pyridium will help to prevent kidney damage from the bladder infection.'
Correct Answer: C
Rationale: Phenazopyridine is a urinary tract anesthetic, relieving pain and burning during urination until antibiotics resolve cystitis. It's not an antibiotic, analgesic, or kidney protectant.
A 75-year-old man following a right total hip replacement. The nurse's notes indicate that since the surgery the patient has become disoriented and confused at night. One evening as the nurse prepares the patient for sleep, the patient glances to his left and says, 'Oh, you think so?' and starts to laugh.
Which of the following responses by the nurse is the BEST?
- A. Do you hear voices talking to you?'
- B. Tell me why you are laughing so I can laugh too.'
- C. What is it that you find amusing?'
- D. I notice you're laughing.'
Correct Answer: D
Rationale: Strategy: Remember therapeutic communication. (1) yes/no question, may make client defensive and block communication (2) feeds into client's altered-reality state, nurse should suspect a hallucination (3) confrontation would block communication (4) correct-therapeutic statement of client's nonverbal communication
The parents of a child with cystic fibrosis discuss nutritional requirements and the need for vitamin supplements with the nurse. The nurse explains that it is necessary to give daily supplements of vitamins A, D, E, and K because:
- A. Children with cystic fibrosis require vitamin supplements because their metabolism is increased.
- B. Children with cystic fibrosis do not eat a well-balanced diet.
- C. Children with cystic fibrosis do not absorb fat-soluble vitamins.
- D. Children with cystic fibrosis have an increased excretion of water-soluble vitamins.
Correct Answer: C
Rationale: Cystic fibrosis impairs fat absorption, leading to deficiencies in fat-soluble vitamins (A, D, E, K), necessitating supplementation.