Nokea
The clinic nurse is providing instructions to a client in the third trimester of pregnancy regarding relief measures for heartburn. Which instruction should the nurse provide to the client?
- A. Sip on milk or hot tea.
- B. Use antacids that contain sodium.
- C. Eat fatty foods once a day in the morning only.
- D. Eat three large meals a day rather than small, frequent meals.
Correct Answer: A
Rationale: Sipping on milk or hot tea can soothe the gastrointestinal tract and relieve heartburn. Antacids containing sodium should be avoided to prevent edema. Fatty foods should be avoided entirely, and small, frequent meals are recommended to reduce heartburn in pregnancy.
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Dipyridamole has been prescribed for the client who underwent a valve replacement, and the nurse has provided teaching to the client about the medication. Which statement indicates that the client understands the medication instructions?
- A. This medication will prevent a stroke.
- B. This medication will prevent a heart attack.
- C. This medicine will protect my artificial heart valve.
- D. This medication will help me keep my blood pressure down.
Correct Answer: C
Rationale: Dipyridamole is an antiplatelet medication. It may be administered in combination with warfarin sodium to protect the client's artificial heart valves. Dipyridamole does not prevent stroke or heart attacks. It is an antiplatelet medication rather than an antihypertensive.
The nurse is providing instructions to a client and family regarding home care after left-eye cataract removal. The nurse tells the client and family about assuming which position during the postoperative period?
- A. Sleep only on the left side.
- B. Sleep on the right side or the back.
- C. Bend below the waist as often as you are able.
- D. Lower the head between the knees three times a day.
Correct Answer: B
Rationale: After cataract surgery, the client is informed to sleep on the nonoperative side or his or her back. The client should not sleep on the operative side to prevent the development of edema. The client should also avoid bending below the level of the waist or lowering the head because these actions will increase intraocular pressure.
The nurse is caring for a pregnant client at 24 weeks. The client voids before the nurse measures the fundal height. Which finding by the nurse would be expected in assessment of this client?
- A. a fundal height of 22 to 26 cm
- B. a fundal height of 27 to 30 cm
- C. a fundal height of 29 to 33 cm
- D. a fundal height of 31 to 34 cm
Correct Answer: A
Rationale: At 24 weeks, fundal height typically measures 22-26 cm, corresponding to gestational age in centimeters.
The nurse is planning dietary counseling for the client with chronic heart failure taking triamterene. The nurse plans to include which item in a list of foods that are acceptable?
- A. Bananas
- B. Oranges
- C. Baked potato
- D. Canned pears
Correct Answer: D
Rationale: Triamterene is a potassium-retaining diuretic, so high-potassium foods like bananas, oranges, and potatoes should be avoided. Canned pears are lower in potassium, making them acceptable.
The nurse is giving a client with chronic obstructive pulmonary disease (COPD) information related to the positions used to breathe more easily. The nurse teaches the client to assume which position?
- A. Sit bolt upright in bed with the arms crossed over the chest.
- B. Lie on the side with the head of the bed at a 45-degree angle.
- C. Sit in a reclining chair tilted slightly back with the feet elevated.
- D. Sit on the edge of the bed with the arms leaning on an overbed table.
Correct Answer: D
Rationale: Proper positioning can decrease episodes of dyspnea in a client with COPD. Appropriate positions include sitting upright while leaning on an overbed table, sitting upright in a chair with the arms resting on the knees, and leaning against a wall while standing. Sitting bolt upright with arms folded across the chest restricts the movement of the anterior and posterior walls of the lung, and side-lying with the head of bed raised to a 45-degree position restricts the expansion of the lateral wall of the lung. Option 3 restricts posterior lung expansion.