Nokea
The client with atrial fibrillation is being taught about the use of Coumadin (warfarin) at home. Which of these should be emphasized to the client to avoid?
- A. Large indoor gatherings
- B. Exposure to sunlight
- C. Active physical exercise
- D. Foods rich in vitamin K
Correct Answer: D
Rationale: The correct answer is D: Foods rich in vitamin K. Foods rich in vitamin K can interfere with the effectiveness of Coumadin (warfarin) by promoting blood clotting. It is crucial for clients on this medication to maintain a consistent intake of vitamin K and avoid sudden dietary changes. Choices A, B, and C are incorrect as they are not directly related to the interaction of Coumadin (warfarin) with vitamin K. Large indoor gatherings, exposure to sunlight, and active physical exercise do not have a significant impact on the effectiveness of Coumadin (warfarin) in comparison to the interaction with foods rich in vitamin K.
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The community health nurse has been following the care for an adolescent with a history of morbid obesity, asthma, hypertension, and is 22 weeks into a pregnancy. Which of these lab reports sent to the clinic needs to be called to the teen's healthcare provider within the next hour?
- A. Hemoglobin 11 g/dL and calcium 6 mg/dL
- B. Magnesium 0.8 mEq/L and creatinine 3 mg/dL
- C. Blood urea nitrogen 28 mg/dL and glucose 225 mg/dL
- D. Hematocrit 33% and platelets 200,000
Correct Answer: B
Rationale: The correct answer is B. The low magnesium level and elevated creatinine suggest possible renal dysfunction, which is concerning, especially in a pregnant client with multiple risk factors such as morbid obesity, asthma, and hypertension. Immediate attention is needed to address the potential renal issues. The other choices do not indicate such urgent conditions. Hemoglobin and calcium levels in choice A are within acceptable ranges. Choice C shows elevated blood urea nitrogen and glucose levels, which may need monitoring but not immediate attention. Choice D's hematocrit and platelet levels are also within normal ranges and do not indicate an urgent issue.
A community health nurse is planning to implement an outreach program for a community group. Which criteria should the nurse clarify about the program when examining sources for funding?
- A. Focuses on addressing multiple health problems or concerns.
- B. Identifies populations and individuals in need of healthcare services.
- C. Evaluates differences in health services and health status among populations.
- D. Provides healthcare services to community members in local factories, schools, and churches.
Correct Answer: B
Rationale: Identifying populations and individuals in need of healthcare services is essential when seeking funding for an outreach program. This criterion helps demonstrate the relevance and impact of the program on specific groups requiring healthcare services. Choice A is incorrect because while addressing multiple health problems is important, identifying the target population in need of services is more critical for funding considerations. Choice C is incorrect as evaluating variations in health services and status, though valuable, is not directly related to securing funding. Choice D is incorrect as offering services in various community locations is a component of the program's implementation, not a criterion for funding.
Which of the following would be the best strategy for the nurse to use when teaching insulin injection techniques to a newly diagnosed client with diabetes?
- A. Provide written pre and post tests
- B. Ask questions during practice
- C. Allow another diabetic to assist
- D. Observe a return demonstration
Correct Answer: D
Rationale: The best strategy for the nurse to use when teaching insulin injection techniques to a newly diagnosed client with diabetes is to observe a return demonstration. This method ensures that the client can correctly perform the technique. Providing written pre and post tests (choice A) may assess knowledge but not application. Asking questions during practice (choice B) may help with understanding but not necessarily with the actual performance. Allowing another diabetic to assist (choice C) may provide peer support but does not guarantee correct technique demonstration.
A client with acute pancreatitis is receiving total parenteral nutrition (TPN). The nurse should monitor the client for which of the following complications?
- A. Hypoglycemia
- B. Hyperkalemia
- C. Hyperglycemia
- D. Hyponatremia
Correct Answer: C
Rationale: The correct answer is C: Hyperglycemia. Total parenteral nutrition (TPN) contains a high glucose content, which can lead to elevated blood sugar levels, resulting in hyperglycemia. Monitoring for hyperglycemia is crucial in clients receiving TPN to prevent complications such as osmotic diuresis, dehydration, and electrolyte imbalances. Choices A, B, and D are incorrect because TPN is more likely to cause hyperglycemia rather than hypoglycemia, hyperkalemia, or hyponatremia.
Postoperative orders for a client undergoing a mitral valve replacement include monitoring pulmonary artery pressure together with pulmonary capillary wedge pressure with a pulmonary artery catheter. This action by the nurse will assess
- A. Right ventricular pressure
- B. Left ventricular end-diastolic pressure
- C. Acid-Base balance
- D. Coronary artery stability
Correct Answer: B
Rationale: The correct answer is B: Left ventricular end-diastolic pressure. Pulmonary capillary wedge pressure is used to assess left ventricular end-diastolic pressure. This measurement provides valuable information on the filling pressure of the left ventricle. Choices A, C, and D are incorrect because monitoring pulmonary capillary wedge pressure does not directly assess right ventricular pressure, acid-base balance, or coronary artery stability.