Nokea
The client with Ménière'sdisease is instructed to modify his diet. The nurse should explain that the most frequently recommended diet modification for the client's disease is:
- A. Low sodium.
- B. High protein.
- C. Low carbohydrate.
- D. Low fat.
Correct Answer: A
Rationale: A low-sodium diet is recommended for Ménière'sdisease to reduce fluid retention in the inner ear, which can decrease the frequency and severity of vertigo attacks.
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In which of the following clients is an autotransfusion contraindicated?
- A. The client who has cancer.
- B. The client who is in danger of cardiac arrest.
- C. The client with a contaminated wound.
- D. The client with a ruptured bowel.
Correct Answer: A,C,D
Rationale: Autotransfusion is contraindicated in cancer (risk of spreading malignant cells), contaminated wounds, or ruptured bowel (risk of infection or bacterial spread). It may be used cautiously in cardiac arrest if no other contraindications exist.
A client has a Jackson-Pratt drainage tube in place the first day after surgical repair of a ruptured diverticulum. The client asks the nurse the purpose of the drain. What is the nurse's best response?
- A. œThe drainage tube is used to prevent infection in the peritoneal cavity.'
- B. œThe drainage tube is used to prevent bleeding into the peritoneal cavity.'
- C. œThe drainage tube is used to prevent pressure on on the bladder.'
- D. œThe drainage tube is used to prevent pressure on the gallbladder.'
Correct Answer: A
Rationale: A Jackson-Pratt drain removes fluid and blood from the surgical site, preventing infection in the peritoneal cavity by reducing fluid accumulation post-diverticulum repair.
The client with lymphedema has an increased risk of cellulitis and lymphangitis because of:
- A. Fragility of the capillaries.
- B. Myelosuppression of the bone marrow.
- C. Stagnation of accumulated fluid.
- D. Increased use of the extremity.
Correct Answer: C
Rationale: Stagnation of accumulated fluid in lymphedema creates an environment conducive to bacterial growth, increasing the risk of cellulitis and lymphangitis.
A client is admitted with a myocardial infarction and new onset atrial fibrillation. While auscultating the heart, the nurse notes an irregular heart rate and hears an extra heart sound at the apex after the S2 that remains constant throughout the respiratory cycle. The nurse should document these findings as:
- A. Heart rate irregular with S3.
- B. Heart rate irregular with S4.
- C. Heart rate irregular with aortic regurgitation.
- D. Heart rate irregular with mitral stenosis.
Correct Answer: A
Rationale: An extra heart sound after S2 at the apex, constant through the respiratory cycle, is an S3, often associated with heart failure post-myocardial infarction. Atrial fibrillation causes an irregular heart rate.
A nurse is caring for a client who has just returned from surgery to treat a fractured mandible. Which of the following items should always be available at this client's bedside? Select all that apply.
- A. Nasogastric tube.
- B. Wire cutters.
- C. Oxygen cannula.
- D. Suction equipment.
- E. Code cart.
Correct Answer: B,D
Rationale: For a client with a wired jaw due to a fractured mandible, wire cutters are essential in case of an emergency, such as vomiting, to quickly release the wires and prevent aspiration. Suction equipment is also critical to maintain a patent airway by removing secretions or vomit. A nasogastric tube, oxygen cannula, and code cart are not routinely required at the bedside unless specifically indicated.