Nokea
The client asks how he contracted hepatitis A. He reports all of the following. Which one is most likely related to hepatitis A?
- A. He ate home-canned corn.
- B. He ate oysters his roommate brought home from a fishing trip.
- C. He stepped on a nail two weeks ago.
- D. He donated blood two weeks before he got sick.
Correct Answer: B
Rationale: Hepatitis A is transmitted via the fecal-oral route, often through contaminated food like oysters. Oysters from unsafe waters are a common source.
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The nurse is caring for clients on a medical unit. Which client information should be brought to the attention of the HCP immediately?
- A. A serum sodium of 128 mEq/L in a client diagnosed with obstipation.
- B. The client diagnosed with fecal impaction who had two (2) hard formed stools.
- C. A serum potassium level of 3.8 mEq/L in a client diagnosed with diarrhea.
- D. The client with diarrhea who had two (2) semiliquid stools totaling 300 mL.
Correct Answer: A
Rationale: Hyponatremia (sodium 128 mEq/L) in obstipation risks neurological complications, requiring immediate HCP attention. Formed stools, normal potassium, and moderate diarrhea are less urgent.
The nurse is caring for the client one (1) day postoperative sigmoid colostomy. Which independent nursing intervention should the nurse implement?
- A. Change the infusion rate of the intravenous fluid.
- B. Encourage the client to ventilate feelings about body image.
- C. Administer opioid narcotic medications for pain management.
- D. Assist the client out of bed to sit in the chair twice daily.
Correct Answer: B
Rationale: Encouraging ventilation of feelings about body image is an independent nursing intervention addressing psychosocial needs post-colostomy. IV rate, opioids, and ambulation require orders or are less psychosocial.
Which intervention should the nurse implement when administering a potassium supplement?
- A. Determine the client's allergies.
- B. Ask the client about leg cramps.
- C. Monitor the client's blood pressure.
- D. Monitor the client's complete blood count.
Correct Answer: B
Rationale: Asking about leg cramps assesses for hypokalemia symptoms, ensuring the potassium supplement is needed and effective. Allergies, BP, and CBC are less specific.
The client in end-stage liver failure has vitamin K deficiency. Which interventions should the nurse implement?
- A. Avoid rectal temperatures.
- B. Use only a soft toothbrush.
- C. Monitor the platelet count.
- D. Use small-gauge needles.
- E. Assess for asterixis.
Correct Answer: A,B,D
Rationale: Vitamin K deficiency impairs clotting, increasing bleeding risk, so avoiding rectal temperatures, using a soft toothbrush, and small-gauge needles minimize trauma. Platelet counts and asterixis are unrelated to bleeding risk.
The nurse is reviewing the health history of the client receiving treatment for hemorrhoids. Which information, related to the development of hemorrhoids, should the nurse expect to find in the client’s medical history?
- A. Body mass index of 18
- B. Chronic constipation
- C. Nulliparous female
- D. Works as a salesperson
- E. Taking iron supplements
Correct Answer: B, E
Rationale: Clients who are thin (BMI = 18) would have a decreased risk of hemorrhoid development. Obesity is a risk factor for hemorrhoid development. B. Prolonged constipation is a risk factor for development of hemorrhoids. C. Since pregnancy is a common cause of constipation, nulliparous women would have a decreased risk of hemorrhoid development. D. Sedentary rather than active occupations have an increased risk of hemorrhoid development. E. Iron supplements can lead to constipation and straining, which can precipitate hemorrhoid development.