Nokea
Place in sequence from 1-5 the proper order for introducing items to the infant's diet.
- A. Strained meats
- B. Whole milk
- C. Rice cereal
- D. Fruits
- E. Vegetables
Correct Answer: C, D, E, A, B
Rationale: Infant diet sequence: rice cereal (C) at 6 months, then fruits (D) and vegetables (E), strained meats (A) around 7-8 months, and whole milk (B) after 12 months.
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After several days, an IDDM client's serum glucose stabilizes, and the registered nurse continues client teaching in preparation for his discharge. The nurse helps him plan an American Diabetes Association diet and explains how foods can be substituted on the exchange list. He can substitute 1 oz of poultry for:
- A. One frankfurter
- B. One ounce of ham
- C. Two slices of bacon
- D. One-fourth cup dry cottage cheese
Correct Answer: D
Rationale: Diabetic meat-exchange lists are categorized into lean-meat foods, medium-fat meats, and high-fat meats. Cottage cheese (dry, 2% butterfat), one-fourth cup, can substitute for one lean-meat exchange.
A 74-year-old female client is 3 days postoperative. She has an indwelling catheter and has been progressing well. While the nurse is in the room, the client states, 'Oh dear, I feel like I have to urinate again!' Which of the following is the most appropriate initial nursing response?
- A. Assure her that this is most likely the result of bladder spasms.
- B. Check the collection bag and tubing to verify that the catheter is draining properly.
- C. Instruct her to do Kegel exercises to diminish the urge to void.
- D. Ask her if she has felt this way before.
Correct Answer: B
Rationale: The most frequent reason for an urge to void with an indwelling catheter is blocked tubing, so checking the catheter's patency is the best initial response.
Which of the following signs might indicate a complication during the labor process with vertex presentation?
- A. Fetal tachycardia to 170 bpm during a contraction
- B. Nausea and vomiting at 8-10 cm dilation
- C. Contraction lasting 60 seconds
- D. Appearance of dark-colored amniotic fluid
Correct Answer: D
Rationale: Fetal tachycardia may indicate fetal hypoxia; however, 170 bpm is only mild tachycardia. Nausea and vomiting occur frequently during transition and are not a complication. Contractions frequently last 60-90 seconds during the transitional phase of labor and are not considered a complication as long as the uterus relaxes completely between contractions. Passage of meconium in a vertex presentation is a sign of fetal distress; this may be normal in a breech presentation owing to pressure on the presenting part.
Which action by the healthcare worker indicates a need for further teaching?
- A. The nursing assistant ambulates the elderly client using a gait belt.
- B. The nurse wears goggles while performing a venipuncture.
- C. The nurse washes his hands after changing a dressing.
- D. The nurse wears gloves to monitor the IV infusion rate.
Correct Answer: D
Rationale: Wearing gloves to monitor an IV infusion rate is unnecessary unless contact with bodily fluids is anticipated indicating a need for further teaching on standard precautions. The other actions are appropriate safety measures.
The nurse is caring for a client following a myocardial infarction. Which of the following enzymes are specific to cardiac damage?
- A. SGOT and LDH
- B. SGOT and CK BB
- C. LDH and CK MB
- D. LDH and CK BB
Correct Answer: C
Rationale: CK-MB and LDH are specific to cardiac damage, with CK-MB being highly specific for myocardial infarction due to its presence in heart muscle.