Nokea
The home care nurse is preparing a teaching plan for a client with deficiencies in folic acid. Which foods will increase the clients' folic acid level?
- A. Broccoli
- B. Cabbage
- C. Chicken
- D. Dried fruit
- E. White bread
- F. Milk
Correct Answer: A, B, D
Rationale: Folic acid-rich foods include broccoli (A), cabbage (B), and dried fruit (D). Chicken (C), white bread (E), and milk (F) are low in folate.
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A 4-year-old child has Down syndrome. The community health nurse has coordinated a special preschool program. The nurse's primary goal is to:
- A. Provide respite care for the mother
- B. Facilitate optimal development
- C. Provide a demanding and challenging educational program
- D. Prepare child to enter mainstream education
Correct Answer: B
Rationale: The primary goal for a child with Down syndrome is to facilitate optimal growth and development through tailored interventions.
The nurse assesses a postoperative mastectomy client and notes the breath sounds are diminished in both posterior bases. The nurse's action should be to:
- A. Encourage coughing and deep breathing each hour
- B. Obtain arterial blood gases
- C. Increase O2 from 2-3 L/min
- D. Remove the postoperative dressing to check for bleeding
Correct Answer: A
Rationale: Decreased or absent breath sounds are frequently indicators of postoperative atelectasis. Arterial blood gases are not indicated because there is no other information indicating impending danger. Increasing O2 rate is not indicated without additional information. Removing the dressing is not indicated without additional information.
The physician has ordered Dilantin (phenytoin) 100 mg intravenously for a client with generalized tonic clonic seizures. The nurse should administer the medication:
- A. Rapidly with an IV push
- B. With IV dextrose
- C. Slowly over 2-3 minutes
- D. Through a small vein
Correct Answer: C
Rationale: Phenytoin must be administered slowly (over 2-3 minutes) to prevent cardiovascular complications like hypotension or arrhythmias. It should not be mixed with dextrose or given rapidly.
The nurse has been caring for a 16-year-old female who recently experienced date rape. After having had crisis intervention and been hospitalized for 2 weeks, the nurse knows that the client is effectively coping with the rape when she tells the nurse:
- A. I know it was my fault that it happened, because I shouldn't have been out so late.'
- B. If I had not worn that sexy dress that night, he wouldn't have raped me.'
- C. I know my date just had so much passion he couldn't handle me saying 'no.'
- D. I know now that it was not my fault, but I want to continue counseling after my discharge.'
Correct Answer: D
Rationale: The client has insight into the rape; she does not believe it was her fault and shows good judgment in deciding to continue with counseling after discharge.
A client has a history of alcoholism. He is currently diagnosed with cirrhosis of the liver. The nurse would expect him to be on which type of diet?
- A. High protein and high calorie
- B. High calorie and high carbohydrate
- C. Low-fat 2-g sodium diet
- D. High protein and high fat
Correct Answer: B
Rationale: High carbohydrates provide high-caloric content to prevent tissue catabolism.