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The nurse has completed the admission assessment of a client and has determined that the client's body mass index (BMI) is 33.5 kg/m2. What health promotion advice should the nurse provide to the client?
- A. It would be very helpful if you could integrate more physical activity into your routine.
- B. You're considered to be overweight, so you should be diligent about maintaining a healthy diet.
- C. You might want to consider some of the surgical options that have been developed for treating obesity.
- D. With your permission, I'd like you to refer to a support group for individuals who live with severe obesity.
Correct Answer: A
Rationale: Step-by-step rationale for the correct answer (A):
1. BMI of 33.5 indicates the client is in the overweight category.
2. Physical activity can help in weight management and improving overall health.
3. Integrating physical activity can help in reducing weight and lowering BMI.
4. Health promotion advice should focus on lifestyle changes rather than surgical interventions or support groups.
Summary of why other choices are incorrect:
B: While maintaining a healthy diet is important, focusing solely on diet may not be as effective as incorporating physical activity for weight management.
C: Surgical options are typically considered for severe obesity cases, which may not be necessary at a BMI of 33.5.
D: Referring to a support group for severe obesity may not be appropriate at this stage as lifestyle modifications should be the initial approach.
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The client is receiving intravenous vancomycin. Which assessment finding should the nurse report immediately?
- A. Red man syndrome.
- B. Blood pressure of 130/80 mm Hg.
- C. Mild itching at the IV site.
- D. Nausea and vomiting.
Correct Answer: A
Rationale: The correct answer is A: Red man syndrome. This is a severe adverse reaction to vancomycin characterized by flushing, rash, hypotension, and tachycardia. It can progress rapidly to anaphylaxis. Immediate reporting is crucial for prompt intervention. Blood pressure of 130/80 mm Hg is within normal range, mild itching at the IV site is common and can be managed topically, and nausea and vomiting are common side effects of vancomycin but are not life-threatening compared to Red man syndrome.
A client returns to the unit after a neck dissection. The surgeon placed a Jackson-Pratt drain in the wound. When assessing the wound drainage over the first 24 postoperative hours, what finding would prompt the nurse to notify the health care provider immediately?
- A. Presence of small blood clots in the drainage
- B. 60 mL of milky or cloudy drainage
- C. Spots of drainage on the dressings surrounding the drain
- D. 120 mL of serosanguinous drainage
Correct Answer: B
Rationale: The correct answer is B: 60 mL of milky or cloudy drainage. This finding could indicate the presence of an infection, which is a serious complication post-neck dissection. Milky or cloudy drainage may contain pus, indicating the need for immediate intervention to prevent further complications.
A: Presence of small blood clots in the drainage is relatively common and may not necessarily indicate a problem unless there are large clots or excessive bleeding.
C: Spots of drainage on the dressings surrounding the drain are expected and do not necessarily warrant immediate notification unless there is excessive leakage.
D: 120 mL of serosanguinous drainage is within the expected range for the first 24 hours postoperatively and may not be a cause for immediate concern unless there are other symptoms present.
A healthcare professional is preparing to administer digoxin 0.25 mg PO daily. The amount available is digoxin 0.125 mg tablets. How many tablets should the healthcare professional administer? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)
- A. 1
- B. 2
- C. 3
- D. 4
Correct Answer: B
Rationale: The correct answer is B: 2 tablets. To administer 0.25 mg of digoxin daily using 0.125 mg tablets, the healthcare professional should give 2 tablets. Each tablet is 0.125 mg, so 2 tablets will equal 0.25 mg, which is the required dose. The other choices are incorrect because administering 1 tablet would only provide 0.125 mg (half the required dose), administering 3 tablets would provide 0.375 mg (exceeding the required dose), and administering 4 tablets would provide 0.5 mg (double the required dose). Thus, the correct answer is to administer 2 tablets to achieve the prescribed 0.25 mg dose.
A client with a history of chronic alcohol abuse is at risk for which of the following conditions?
- A. Liver cirrhosis
- B. Renal failure
- C. Chronic obstructive pulmonary disease (COPD)
- D. Peptic ulcer disease
Correct Answer: A
Rationale: The correct answer is A: Liver cirrhosis. Chronic alcohol abuse is a leading cause of liver cirrhosis due to the toxic effects of alcohol on the liver over time. Alcohol metabolism leads to liver inflammation, scarring, and ultimately cirrhosis. Renal failure (B) is not directly linked to alcohol abuse but can occur in severe cases. COPD (C) is primarily caused by smoking, not alcohol abuse. Peptic ulcer disease (D) can be exacerbated by alcohol but is not directly caused by chronic alcohol abuse. Therefore, the most significant risk for a client with a history of chronic alcohol abuse is developing liver cirrhosis.
The nurse is providing an educational workshop about coronary artery disease (CAD) and its risk factors. The nurse explains to participants that CAD has many risk factors, some that can be controlled and some that cannot. What risk factors should the nurse list that can be controlled or modified?
- A. Gender, obesity, family history, and smoking
- B. Inactivity, stress, gender, and smoking
- C. Cholesterol levels, hypertension, and smoking
- D. Stress, family history, and obesity
Correct Answer: C
Rationale: The correct answer is C because cholesterol levels, hypertension, and smoking are modifiable risk factors for CAD. High cholesterol levels can be controlled through diet and medication. Hypertension can be managed through lifestyle changes and medication. Smoking is a behavior that can be modified.
A is incorrect because gender and family history are non-modifiable risk factors. Obesity can be controlled but is not listed in the correct answer.
B is incorrect because inactivity and stress are modifiable risk factors, but gender is not modifiable.
D is incorrect because stress and family history are non-modifiable risk factors, and obesity is not listed in the correct answer.