Nokea
The nurse has completed teaching the client about his low-sodium, low-fat diet. Which menu, if selected by the client, would indicate to the nurse that the client understands his diet?
- A. Mashed potatoes, spinach, and meatloaf
- B. Swordfish with Hollandaise sauce, carrots, and rice pilaf
- C. Baked chicken, wild rice, and broccoli
- D. Roast beef with gravy, baked potato with sour cream, and creamed peas
Correct Answer: C
Rationale: Baked chicken, wild rice, and broccoli are low in sodium and fat, aligning with the diet. Meatloaf, Hollandaise, and gravy/sour cream/creamed peas are high in sodium or fat.
You may also like to solve these questions
The school nurse is conducting an educational session for middle school teachers that is designed to heighten awareness of school bullying. The nurse recognizes that further instruction is needed when one of the teachers makes which comment?
- A. Bullying is a normal part of childhood growth and development.
- B. Children with physical disabilities are more vulnerable to bullying.
- C. Most children who are victims of a school bully do not tell an adult about it.
- D. The most common form of bullying is verbal aggression, such as insults and intimidation.
Correct Answer: A
Rationale: Bullying is not a normal part of development (A) and requires intervention. Vulnerability of disabled children (B), underreporting (C), and verbal aggression (D) are accurate.
The nurse prepares to administer a cleansing enema to a client with constipation. Which interventions are appropriate? Select all that apply.
- A. Apply a water-based lubricant to the enema tube before insertion
- B. Assist the client into left lateral position with right knee flexed
- C. Encourage the client to retain the enema for as long as possible
- D. Keep the enema solution refrigerated until ready to administer
- E. Stop the infusion briefly if the client reports abdominal cramping
Correct Answer: A,B,C,E
Rationale: Lubricating the tube (A), left lateral positioning (B), retaining the enema (C), and pausing for cramping (E) are correct for safe administration. Refrigerating the solution (D) is incorrect; it should be at body temperature.
The nurse admits a 2 year-old child who has had a seizure. Which of the following statement by the child's parent would be important in determining the etiology of the seizure?
- A. He has been taking long naps for a week.'
- B. He has had an ear infection for the past 2 days.'
- C. He has been eating more red meat lately.'
- D. He seems to be going to the bathroom more frequently.'
Correct Answer: B
Rationale: He has had an ear infection for the past 2 days.' Contributing factors to seizures in children include those such as age (more common in first 2 years), infections (late infancy and early childhood), fatigue, not eating properly and excessive fluid intake or fluid retention.
An adult comes to the physician's office with a history of headache yesterday and today and pain in the back. The nurse observes a horizontal band of pustular rash on the back extending from the spine to midline in the front. The client describes it as very painful. What would the nurse expect to be prescribed for this client?
- A. Antiviral
- B. Antibiotics
- C. Topical hydrocortisone
- D. Benadryl
Correct Answer: A
Rationale: The painful, unilateral, dermatomal pustular rash suggests herpes zoster (shingles), treated with antivirals like acyclovir.
The nurse is caring for a client with a tracheostomy who has an order to begin oral intake. Which of the following actions should the nurse take to decrease the client's risk for aspiration?
- A. Fully inflate the tracheostomy cuff before the client begins to eat.
- B. Encourage the client to use a straw when drinking fluids.
- C. Instruct the client to tilt the head back when swallowing
- D. Provide thickened liquids for the client.
Correct Answer: D
Rationale: Thickened liquids (D) reduce aspiration risk by slowing transit. Inflating the cuff (A) is not always necessary, straws (B) may increase risk, and tilting the head back (C) worsens aspiration.