Nokea
The nurse evaluates the nutritional intake of a 16-year-old girl at a camp for adolescents. The girl eats all of the food provided to her at the camp cafeteria. Each of the day's three meals contains foods from all areas of the food pyramid, and each meal averages about 900 calories and 3 mg of iron. The girl has been menstruating monthly for about two years. Which of the following descriptions, if made by the nurse, BEST describes the girl's intake if her weight is appropriate for her height?
- A. Her diet is low in calories and high in iron.
- B. Her diet is low in calories and low in iron.
- C. Her diet is high in calories and low in iron.
- D. Her diet is high in calories and high in iron.
Correct Answer: C
Rationale: 900 × 3 = 2,700 calories/day and women need 1,200-1,500 kcal/day (men need 1,500-1,800 kcal/day); 3 mg × 3 = 9 mg/day of iron and women need 15 mg/day of iron (men need 10 mg/day); with pregnancy 30 mg/day required
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A home care nurse is planning activities for the day. Which of the following clients should the nurse see FIRST?
- A. A new mother is breastfeeding her two-day-old infant who was born five days early.
- B. A man discharged yesterday following treatment with IV heparin for a deep vein thrombosis.
- C. An elderly woman discharged from the hospital three days ago with pneumonia.
- D. An elderly man who used all his diuretic medication and is expectorating pink-tinged mucus.
Correct Answer: D
Rationale: symptoms of pulmonary edema; requires immediate attention
A client is readmitted with a recurrent urinary tract infection. The client is to be discharged home on methenamine mandelate (Mandelamine). The nurse should instruct the client to limit intake of which of the following fluids?
- A. Milk.
- B. Juices.
- C. Water.
- D. Tea.
Correct Answer: A
Rationale: should limit intake of alkaline foods and fluids, such as milk
A five-year-old boy in the playroom.
The school nurse observes a group of preschool children in the playroom. The nurse recognizes which of the following activities as appropriate behavior for a five-year-old boy?
- A. The boy plays with a large truck with another child.
- B. The boy talks on a toy telephone and imitates his father.
- C. The boy works on a puzzle with several other children.
- D. The boy holds and cuddles a large stuffed animal.
Correct Answer: B
Rationale: Strategy: Picture the child. (1) play begins to be cooperative at this age (2) correct-imitative behavior seen at this age (3) too advanced for this age (4) too regressed for this age
The nurse is caring for a child with cystic fibrosis. The nurse would anticipate that the child would be deficient in which vitamins?
- A. B, D, and K
- B. A, D, and K
- C. A, C, and D
- D. A, B, and C
Correct Answer: B
Rationale: A, D, and K. The uptake of fat soluble vitamins is decreased in children with Cystic Fibrosis. Vitamins A, D, and K are fat soluble and are likely to be deficient in clients with Cystic Fibrosis.
The nurse is caring for clients in the student health center.
- A. What is the best response by the nurse to a client whose boyfriend Test ed positive for hepatitis B?
- B. That must have been a real shock to you.'
- C. You should be Test ed for hepatitis B.'
- D. You’ll receive the hepatitis B immune globulin (HBIG).'
- E. Have you had unprotected sex with your boyfriend?'
Correct Answer: D
Rationale: The nurse should first assess the client’s exposure risk, as hepatitis B is transmitted through sexual contact or parenteral routes. Asking about unprotected sex determines the need for Test ing or prophylaxis. Empathizing, recommending Test ing, or discussing HBIG are secondary to assessing exposure.