Nokea
The nurse has been preparing a client diagnosed with chronic obstructive pulmonary disease for discharge. Which statement by the client indicates the need for further teaching about nutrition?
- A. I will rest a few minutes before I eat.
- B. I will not eat as much cabbage as I once did.
- C. I will certainly try to drink 3 L of fluid every day.
- D. It's best to eat three large meals a day, so that I will get all my nutrients.
Correct Answer: D
Rationale: Large meals distend the abdomen and elevate the diaphragm, which may interfere with breathing for the client diagnosed with chronic obstructive pulmonary disease. Resting before eating may decrease the fatigue that is often associated with chronic obstructive pulmonary disease. Gas-forming foods may cause bloating, which interferes with normal diaphragmatic breathing. Adequate fluid intake helps liquefy pulmonary secretions.
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The home care nurse visits a client who was recently diagnosed with cirrhosis and provides home care management instructions to the client. Which statement by the client indicates the need for further teaching?
- A. I will obtain adequate rest.
- B. I should monitor my weight regularly.
- C. I will take Tylenol if I get a headache.
- D. I should include sufficient carbohydrates in my diet.
Correct Answer: C
Rationale: Cirrhosis is a chronic liver disease, and acetaminophen (Tylenol) should be avoided because it can cause fatal liver damage in clients with cirrhosis. Adequate rest, regular weight monitoring, and sufficient carbohydrate intake (2000 to 3000 calories daily) are appropriate for managing cirrhosis.
After a cleft lip repair, the nurse instructs the parents about cleaning of the lip repair site. The nurse should plan to use which solution when demonstrating this procedure to the parents?
- A. Tap water
- B. Sterile water
- C. Full-strength hydrogen peroxide
- D. Half-strength hydrogen peroxide
Correct Answer: B
Rationale: After cleft lip repair, the site is cleansed with sterile water using a cotton swab after feeding and as prescribed. Agency procedure should also be followed. The parents should be instructed to use a rolling motion starting at the suture line and rolling out. Tap water is not a sterile solution. Hydrogen peroxide may disrupt the integrity of the site.
The home care nurse has given instructions to a client who was recently discharged from the hospital regarding the care of an arterial ischemic leg ulcer. The nurse determines that there is a need for further teaching if the client makes which statement?
- A. I should inspect my feet daily.
- B. I should wear shoes and socks.
- C. I should cut my toenails straight across.
- D. I should raise my legs above the level of my heart periodically.
Correct Answer: D
Rationale: Raising legs above heart level is inappropriate for arterial ischemic ulcers, as it reduces blood flow to the extremities, worsening ischemia. Daily foot inspection, wearing shoes and socks, and cutting toenails straight across are correct care measures.
The nurse is teaching a client with acute kidney injury to include proteins in the diet that are considered high quality or complete proteins. The nurse determines that the client needs further teaching if he indicates that which food item is considered high quality?
- A. Fish
- B. Eggs
- C. Chicken
- D. Broccoli
Correct Answer: D
Rationale: High-quality or complete proteins, which contain essential amino acids, come from animal sources like fish, eggs, and chicken. Broccoli, a plant-based source, provides low-quality or incomplete proteins, indicating the client's misunderstanding.
The nurse is caring for a client who is 38 weeks pregnant and plans to breastfeed. This is the client's first child, and she expresses concern about lactation. The nurse tells the client that which measures stimulate lactation? Select all that apply.
- A. breast massage
- B. frequent breastfeeding
- C. pumping breasts between feedings
- D. vigorous exercise one week after birth
- E. applying cold compresses to the breasts
Correct Answer: A,B,C
Rationale: Breast massage, frequent breastfeeding, and pumping stimulate milk production. Exercise and cold compresses do not.