Nokea
If the client identifies that lunches often include the following foods, which meal is the most nutritious?
- A. Tossed salad, rice, and iced tea
- B. Apple sandwich on whole wheat bread and coffee
- C. Meatless chili with beans, corn bread, and milk
- D. Chicken soup, gelatin, and sweetened lemonade
Correct Answer: C
Rationale: Meatless chili with beans, corn bread, and milk provides protein, carbohydrates, and calcium, making it the most balanced and nutritious option.
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You're educating a patient about Warfarin (Coumadin) and how it is used to treat blood clots. Which statements by the patient require you to re-educate them about how this medication works? Select all that apply:
- A. This medication will help dissolve the blood clot.
- B. This medication will prevent another blood clot from forming.
- C. This medication will help prevent the blood clot from becoming bigger in size.
- D. This medication starts working immediately after the first dose.
Correct Answer: A,D
Rationale: Warfarin (Coumadin) does NOT dissolve blood clots. It prevents blood clots from forming, and if one is present, it will help prevent it from becoming bigger. If the blood clot becomes bigger it may break off and travel in blood circulation. This can lead to a pulmonary embolism, heart attack, or stroke. Warfarin (Coumadin) does NOT start working immediately. It takes about 3-5 days of scheduled doses to start achieving a therapeutic INR level. It is very common that a patient will be on Heparin while taking Warfarin until INR levels are therapeutic.
The client diagnosed with lung cancer is in an investigational program and receiving a vaccine to treat the cancer. Which information regarding investigational regimens should the nurse teach?
- A. Investigational regimens provide a better chance of survival for the client.
- B. Investigational treatments have not been proven to be helpful to clients.
- C. Clients will be paid to participate in an investigational program.
- D. Only clients who are dying qualify for investigational treatments.
Correct Answer: B
Rationale: Investigational treatments (B) lack proven efficacy, requiring informed consent. Better survival (A), payment (C), and terminal status (D) are incorrect.
Your patient, who is receiving Pyrazinamide, report stiffness and extreme pain in the right big toe. The site is extremely red, swollen, and warm. You notify the physician and as the nurse you anticipated the doctor will order?
- A. Calcium level
- B. Vitamin B6 level
- C. Uric acid level
- D. Amylase level
Correct Answer: C
Rationale: This medication can increase uric acid levels which can lead to gout. The patient's signs and symptoms are classic findings in a gout attack.
The HCP has recommended a total laryngectomy for a male client diagnosed with cancer of the larynx but the client refuses. Which intervention by the nurse illustrates the ethical principle of nonmalfeasance?
- A. The nurse listens to the client explain why he is refusing surgery.
- B. The nurse and significant other insist that the client have the surgery.
- C. The nurse refers the client to a counselor for help with the decision.
- D. The nurse asks a cancer survivor to come and discuss the surgery with the client.
Correct Answer: A
Rationale: Listening to the client’s reasons (A) respects autonomy and avoids harm (nonmalfeasance). Insisting (B), counseling (C), and survivor talks (D) may pressure or influence unduly.
A patient is being discharged home on Doxycycline for treatment of pneumonia. Which statement by the patient indicates they understood your education material?
- A. I will wear sunscreen when outdoors.'
- B. I will avoid green leafy vegetables while taking this medication.'
- C. I will monitor my blood glucose regularly due to the side effects of hypoglycemia.'
- D. I will take this medication with a full glass of milk.'
Correct Answer: A
Rationale: Doxycycline causes photosensitivity, so wearing sunscreen is correct. Green leafy vegetables are relevant for warfarin, hypoglycemia is not a side effect, and milk can reduce doxycycline absorption.