Nokea
In planning the post-operative care for a morbidly obese client, how can the expertise of the LPN/LVN best be applied?
- A. Obtain an oversized blood pressure cuff and a large-size bed.
- B. Set up a reinforced trapeze bar.
- C. Assist in the planning of bathing, turning, and ambulation.
- D. Design alternatives for routine tasks such as daily weights.
Correct Answer: C
Rationale: The correct answer is C because LPN/LVNs can assist in planning bathing, turning, and ambulation for a morbidly obese client. This is crucial in preventing complications such as pressure ulcers, deep vein thrombosis, and respiratory issues. LPN/LVNs can provide physical support and guidance to ensure the client's safety and comfort during these activities.
Choice A is incorrect because obtaining oversized equipment is not the primary role of LPN/LVNs. Choice B is also incorrect as setting up a reinforced trapeze bar is more of a facility management task. Choice D is incorrect as designing alternatives for routine tasks is not within the scope of practice for LPN/LVNs.
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An 82-year-old man is admitted with an acute attack of diverticulitis. What should the nurse include in his care?
- A. Monitor for signs of peritonitis.
- B. Treat with daily medicated enemas.
- C. Prepare for surgery to resect the involved colon.
- D. Provide a heating pad to apply to the left lower quadrant.
Correct Answer: A
Rationale: The correct answer is A: Monitor for signs of peritonitis. Peritonitis is a serious complication of diverticulitis that can result from a rupture of inflamed diverticula leading to abdominal infection. Monitoring for signs such as severe abdominal pain, rigidity, and fever is crucial for early detection and prompt intervention. Option B is incorrect as daily medicated enemas are not the standard treatment for diverticulitis. Option C is also incorrect as surgery is usually reserved for complicated cases or recurrent attacks. Option D is incorrect because applying a heating pad may exacerbate inflammation and is not recommended in diverticulitis management.
The family members of a patient with hepatitis A ask if there is anything that will prevent them from developing the disease. What is the best response by the nurse?
- A. No immunization is available for hepatitis A, nor are you likely to get the disease.'
- B. All family members should receive the hepatitis A vaccine to prevent or modify the infection.'
- C. Those who have had household or close contact with the patient should receive immune globulin.'
- D. Only those individuals who have had sexual contact with the patient should receive immunization.'
Correct Answer: C
Rationale: The correct answer is C: Those who have had household or close contact with the patient should receive immune globulin. This is because immune globulin can provide passive immunity to those exposed to hepatitis A, reducing the risk of developing the disease. Hepatitis A vaccine is not effective post-exposure, so it would not prevent disease in this scenario (option B). Option A is incorrect as there is a vaccine available for hepatitis A. Option D is incorrect because hepatitis A is primarily transmitted through fecal-oral route, not sexual contact.
The presence of bilirubin in bile is important because:
- A. It gives bile its color
- B. It leads to production of stercobilinogen in the intestine
- C. It facilitates absorption of lipids
- D. It gives faces their color
Correct Answer: A
Rationale: The correct answer is A: It gives bile its color. Bilirubin is a pigment produced from the breakdown of hemoglobin in the liver, giving bile its characteristic yellow-green color. This is important for bile to aid in the emulsification and digestion of fats. Choices B and D are incorrect as stercobilinogen is produced from bilirubin in the intestine, contributing to stool color, not bile color. Choice C is incorrect as bile salts, not bilirubin, facilitate the absorption of lipids in the small intestine.
The nurse is percussing a patient's abdomen and hears a dull thud in the right upper quadrant. This sound indicates that the nurse is percussing over which location?
- A. The liver
- B. The small intestine
- C. The stomach
- D. The lungs
Correct Answer: A
Rationale: The correct answer is A: The liver. When percussing the abdomen, a dull thud in the right upper quadrant indicates the presence of a solid organ like the liver. The liver is located in the right upper quadrant of the abdomen, making it the most likely source of the dull sound. The other choices are incorrect because the small intestine and stomach are hollow organs, which would produce a tympanic sound when percussed. The lungs are located in the thoracic cavity, not the abdominal cavity, so percussing over the lungs would not produce a sound in the right upper quadrant of the abdomen.
A nurse is instructing a client who has GERD about positions that can help minimize the effects of reflux during sleep. Which of the following statements indicates to the nurse that the client understands the instructions?
- A. I will lie on my left side to sleep at night.'
- B. I will lie on my right side to sleep at night.'
- C. I will sleep on my back with my head flat.'
- D. I will sleep on my stomach with my head flat.'
Correct Answer: A
Rationale: The correct answer is A: "I will lie on my left side to sleep at night." This position helps prevent acid from flowing back into the esophagus due to the angle of the stomach in relation to the esophagus. Lying on the right side can worsen reflux. Sleeping on the back with the head flat can also worsen symptoms as gravity can allow acid to flow back up. Sleeping on the stomach with the head flat is not recommended as it can put pressure on the stomach, leading to increased reflux.