Nokea
The client attends two sessions with the dietitian to learn about diet modifications to minimize gastroesophageal reflux. The teaching would be considered successful if the client says that she will decrease her intake of which of the following foods?
- A. Fats.
- B. High-sodium foods.
- C. Carbohydrates.
- D. High-calcium foods.
Correct Answer: A
Rationale: Decreasing fat intake is key to managing GERD, as fatty foods relax the lower esophageal sphincter and delay gastric emptying, worsening reflux.
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A client who had an exploratory laparotomy 3 days ago has a white blood cell (WBC) differential with a shift to the left. The nurse instructs unlicensed personnel to report which clinical manifestation?
- A. Swelling around the incision.
- B. Redness around the incision.
- C. Elevated temperature.
- D. Purulent wound drainage.
Correct Answer: C
Rationale: A left shift in the WBC differential indicates an increase in immature neutrophils, often due to infection. An elevated temperature is a key sign of infection and should be reported promptly. Swelling, redness, and purulent drainage are also concerning but may develop later.
The client is scheduled for an intravenous pyelogram (IVP) to determine the location of the renal calculi. Which of the following measures would be most important for the nurse to include in pretest preparation?
- A. Ensuring adequate fluid intake on the day of the test.
- B. Preparing the client for the possibility of bladder, the client is history for allergy to iodine.
- C. Determining when the client last had a bowel movement.
Correct Answer: B
Rationale: Checking for iodine allergy is critical for IVP due to the use of iodine-based contrast, which can cause severe allergic reactions.
The nurse is caring for a client diagnosed with an anterior myocardial infarction 2 days ago. Upon assessment, the nurse identifies a new systolic murmur at the apex. The nurse should first:
- A. Assess for changes in vital signs.
- B. Draw an arterial blood gas.
- C. Evaluate heart sounds with the client leaning forward.
- D. Obtain a 12 Lead electrocardiogram.
Correct Answer: A
Rationale: A new systolic murmur post-myocardial infarction may indicate complications like ventricular septal rupture or mitral regurgitation. Assessing vital signs first helps determine the client's stability and guides further actions.
The nurse anticipates that the client who has received epidural anesthesia is at decreased risk for a spinal headache because:
- A. A 17G needle is used.
- B. A subarachnoid injection is made.
- C. A noncutting needle is used.
- D. A faster onset occurs.
Correct Answer: C
Rationale: Epidural anesthesia uses a noncutting needle, reducing dural puncture risk and thus lowering the incidence of spinal headache compared to spinal anesthesia.
The nurse receives emergency laboratory results for a client with chest pain and immediately informs the physician. An increased myoglobin level suggests which of the following?
- A. Cancer.
- B. Hypertension.
- C. Liver disease.
- D. Myocardial damage.
Correct Answer: D
Rationale: Elevated myoglobin indicates myocardial damage, as it is released from injured cardiac muscle, supporting a diagnosis of MI.