Nokea
The client using a diaphragm should be instructed to:
- A. Refrain from keeping the diaphragm in longer than 4 hours
- B. Keep the diaphragm in a cool location
- C. Have the diaphragm resized if she gains 5 pounds
- D. Have the diaphragm resized if she has any surgery
Correct Answer: D
Rationale: Surgery, especially pelvic or abdominal, can alter pelvic anatomy, requiring the diaphragm to be resized for effective contraception.
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The nurse is performing discharge teaching on a client with diverticulitis who has been placed on a low-roughage diet. Which food would have to be eliminated from this client's diet?
- A. Roasted chicken
- B. Noodles
- C. Cooked broccoli
- D. Custard
Correct Answer: C
Rationale: Cooked broccoli is high in fiber and should be avoided on a low-roughage diet for diverticulitis to prevent irritation.
The doctor has prescribed a diet high in vitamin B12 for a client with pernicious anemia. Which foods are good sources of B12?
- A. Meat, eggs, dairy products
- B. Peanut butter, raisins, molasses
- C. Broccoli, cauliflower, cabbage
- D. Shrimp, legumes, bran cereals
Correct Answer: A
Rationale: Vitamin B12 is found in animal products like meat, eggs, and dairy, essential for treating pernicious anemia due to impaired B12 absorption.
The nurse is teaching a client with a new diagnosis of epilepsy about self-care. Which of the following instructions should the nurse include?
- A. Avoid swimming or bathing alone.
- B. Take medications only when a seizure occurs.
- C. Drive a car as long as you feel alert.
- D. Consume alcohol in moderation to reduce stress.
Correct Answer: A
Rationale: avoiding swimming or bathing alone reduces the risk of injury during a seizure
A 34-year-old client is receiving an IM injection of ceftriaxone (Rocephin) for a urinary tract infection. Which is correct regarding IM injections?
- A. A 1-inch-long 25-gauge needle should be used.
- B. The injection should be given at a 45-degree angle.
- C. The injection should be given at a 90-degree angle.
- D. A bleb should form on the skin's surface following injection.
Correct Answer: C
Rationale: IM injections are given at a 90-degree angle to ensure muscle penetration. A 25-gauge needle is too small, a 45-degree angle is for subcutaneous injections, and a bleb indicates intradermal injection.
The nurse is assessing a client following the removal of a pituitary tumor. The nurse notes that the urinary output has increased and that the urine is very dilute. The nurse should give priority to:
- A. Notifying the doctor immediately
- B. Documenting the finding in the chart
- C. Decreasing the rate of IV fluids
- D. Administering vasopressive medication
Correct Answer: A
Rationale: Increased dilute urine suggests diabetes insipidus, a complication of pituitary surgery, requiring immediate physician notification for evaluation and treatment.