Nokea
The nurse has reinforced teaching with a client who has gout. Which of the following statements by the client would indicate a correct understanding of the teaching? Select all that apply.
- A. Drink plenty of fluids, including at least 2 L of water daily
- B. Reduce your consumption of alcohol or abstain from drinking
- C. Take aspirin instead of acetaminophen for minor pain or discomfort
- D. Implement a diet and physical activity regimen to maintain a healthy weight
- E. Select protein sources that are low in purine, such as low-fat dairy products
Correct Answer: A,B,D,E
Rationale: Fluids, reduced alcohol, weight management, and low-purine proteins reduce uric acid and gout flares. Aspirin can increase uric acid levels, worsening gout, and should be avoided.
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The nurse is talking with a client who has gastroesophageal reflux disease and has been receiving long-term therapy with esomeprazole. Which of the following questions would be most important for the nurse to ask?
- A. Have you sustained any bone fractures recently?
- B. Are you experiencing an improved quality of sleep?
- C. Have you been checking your blood pressure regularly?
- D. Are you able to manage stressors in your life effectively?
Correct Answer: A
Rationale: Long-term esomeprazole use increases fracture risk due to reduced calcium absorption, making this the most critical question. Sleep, blood pressure, and stress are less directly related to esomeprazole’s side effects.
The charge nurse is reviewing events that staff nurses experienced during the shift. Which events require an incident/occurrence report to be completed? Select all that apply.
- A. Client determined brain dead was taken off life support
- B. Client with alcohol intoxication physically assaulted a nurse
- C. Serum troponin level was prescribed but never obtained
- D. Staff nurse did not present for work and did not notify management
- E. Visitor fell and refused care in the emergency department
Correct Answer: B,C,D
Rationale: Assault, missed lab tests, and staff no-show are reportable incidents due to safety, care quality, and staffing issues. Brain death withdrawal follows protocol, and a visitor’s fall with refused care is less reportable.
The nurse is reinforcing teaching to a client being discharged on enoxaparin therapy following total knee replacement surgery. Which statement made by the nurse is most appropriate?
- A. Eliminate green, leafy, vitamin K-rich vegetables from your diet
- B. Mild bruising or redness may occur at the injection site
- C. You can take over-the-counter drugs such as ibuprofen to relieve mild discomfort
- D. You will need PT/INR assessments at regular intervals while on enoxaparin therapy
Correct Answer: B
Rationale: Mild bruising or redness at the injection site is a common side effect of enoxaparin, a low-molecular-weight heparin. Vitamin K restriction applies to warfarin, ibuprofen increases bleeding risk, and PT/INR monitoring is not required for enoxaparin.
Damage to the VIII cranial nerve results in:
- A. Air conduction loss
- B. Sensorineural loss
- C. Mixed hearing disorders
- D. Tinnitus
Correct Answer: B
Rationale: The VIII cranial nerve (vestibulocochlear) is responsible for hearing and balance; damage causes sensorineural hearing loss, affecting the inner ear or nerve pathways.
The nurse has reinforced teaching with the parent of a 4-month-old with gastroesophageal reflux. Which of the following statements by the parent would indicate a correct understanding of the teaching? Select all that apply.
- A. I will feed my baby smaller amounts more frequently
- B. I will place my baby in a side-lying position at night for sleep
- C. I will dilute my baby’s formula with water to decrease regurgitation
- D. I should massage my baby’s belly as soon as each feeding is complete
- E. I should hold my baby in an upright position for 20 to 30 minutes after each feeding
Correct Answer: A,E
Rationale: Smaller, frequent feedings and upright positioning reduce reflux. Side-lying is unsafe for sleep, diluting formula risks malnutrition, and massaging the belly post-feeding may increase regurgitation.