Nokea
The most appropriate method of evaluating whether the diet of a child with cystic fibrosis is meeting his caloric needs is:
- A. Careful monitoring of weight loss or gain
- B. Carefully recording amounts and types of foods ingested
- C. Keeping a strict account of the number of calories ingested
- D. Keeping a careful account of the amount of pancreatic enzymes ingested
Correct Answer: A
Rationale: Consistent weight gain, even if it is slow, is an indication that the child is eating and digesting sufficient calories.
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A client with a history of atrial flutter is admitted with complaints of dizziness. The nurse should give priority to:
- A. Monitoring heart rate
- B. Administering pain medication
- C. Monitoring respiratory rate
- D. Administering diuretics
Correct Answer: A
Rationale: Atrial flutter causes rapid heart rates, which can lead to dizziness due to reduced cardiac output, so monitoring heart rate is the priority.
Which of the following activities would be most appropriate during occupational therapy for a client with bipolar disorder?
- A. Playing cards with other clients
- B. Working crossword puzzles
- C. Playing tennis with a staff member
- D. Sewing beads on a leather belt
Correct Answer: C
Rationale: This activity is too competitive, and the manic client might become abusive toward the other clients. During mania, the client's attention span is too short to accomplish this task. This activity uses gross motor skills, eases tension, and expands excess energy. A staff member is better equipped to interact therapeutically with clients. This activity requires the use of fine motor skills and is very tedious.
Which of the following blood values would require further nursing action in a newborn who is 4 hours old?
- A. Hemoglobin 17.2 g/dL
- B. Platelets 250,000/mm3
- C. Serum glucose 30 mg/dL
- D. White blood cells 18,000/mm3
Correct Answer: C
Rationale: A serum glucose of 30 mg/dL in the first 72 hours of life is indicative of hypoglycemia and warrants further intervention.
The client at 30 weeks gestation is admitted with preterm labor. The physician orders indomethacin. The nurse should monitor for which side effect?
- A. Maternal hypertension
- B. Fetal bradycardia
- C. Oligohydramnios
- D. Maternal hypoglycemia
Correct Answer: C
Rationale: Indomethacin a tocolytic can reduce fetal urine output leading to oligohydramnios (low amniotic fluid). Maternal hypertension fetal bradycardia and hypoglycemia are not common side effects of indomethacin.
A 16-year-old client with anorexia nervosa is on an inpatient psychiatric unit. She has a fear of gaining weight and is refusing to eat sufficient amounts to maintain body weight for her age, height, and stature. To assist with the problem of powerlessness and plan for the client to no longer need to withhold food to feel in control, the nurse uses the following strategy:
- A. Establish a structured environment with routine tasks and activities. Also, serve meals at the same time each day.
- B. Distract the client during meals to get her to eat because she must take in sufficient amounts to keep from starving.
- C. Do frequent room checks to be sure that the client is not hiding food or throwing it away.
- D. Listen attentively and participate in in-depth discussions about food, because these actions may encourage her to eat.
Correct Answer: A
Rationale: Anorexia nervosa clients feel out of control. Providing a structured environment offers safety and comfort and can help them to develop internal control, thus reducing their need to control by self-starvation. Distraction does not focus on the client's need for control. Doing frequent room checks reinforces feelings of powerlessness and the need to continue with the dysfunctional behavior. Participating in long discussions about food does not make the client want to eat, but rather this strategy allows her to indulge in her preoccupation and to continue with the dysfunctional behavior.