Nokea
The nurse has taught the parents of a 6-year-old client with cystic fibrosis who has a prescription for pancreatic enzymes. Which of the following statements by a parent would require follow-up?
- A. It is acceptable for my child to chew the medication before swallowing it
- B. I should give the medication with or just before my child has a meal or snack
- C. I need to monitor the total amount of medication that I give to my child every day.
- D. It is acceptable to open the capsule and sprinkle the medication on a tablespoon of applesauce.
Correct Answer: A
Rationale: Chewing pancreatic enzymes destroys the enteric coating, reducing efficacy. Timing with meals , monitoring doses , and sprinkling on applesauce are correct practices.
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At the geriatric day care program a client is crying and repeating 'I want to go home. Call my daddy to come for me.' The nurse should
- A. Inform the client that she must wait until the program ends at 5:00 pm to leave
- B. Give the client simple information about what she will be doing
- C. Tell the client you will call someone to come for her and suggest joining the exercise group while she waits
- D. Firmly direct the client to her assigned group activity
Correct Answer: C
Rationale: Tell the client you will call someone to come for her and suggest joining the exercise group while she waits. This uses comforting and distraction to reduce distress in dementia.
The clinic nurse is interviewing the parents of a 6-month-old client about the infant's diet. Which statement by the parents is most concerning?
- A. Because apples are healthy, we make apple pie and feed small, soft bites to our baby.
- B. If our baby refuses to finish foods, we continue to offer small bites, so food isn't wasted.
- C. Infant oatmeal sweetened with fresh honey is our baby's favorite breakfast.
- D. We found that the food in TV dinners can be easily pureed and is convenient.
Correct Answer: C
Rationale: Honey poses a botulism risk in infants under 1 year, making it the most concerning. Apple pie and TV dinners are inappropriate but less dangerous, and offering bites is not harmful.
The health care provider (HCP) provides education to an adult client about an upcoming surgical procedure. The client states, 'I'm not clear on what is included in the low-fat diet that I'll be on after the cholecystectomy.' What action should the nurse take?
- A. Ask the client's family member to sign the consent form
- B. Inform the client that the HCP can discuss all questions after surgery
- C. Provide the client with educational materials about low-fat diet options
- D. Reinforce education about the procedure using a visual aid
Correct Answer: C
Rationale: Providing dietary education addresses the client's question directly. Family consent is inappropriate, postponing discussion delays clarification, and procedure education doesn't address diet.
The nurse reinforces discharge teaching to a client who had a total knee replacement 4 days ago. Which client statement indicates the need for additional teaching?
- A. I have to give myself shots in the belly because my spouse is afraid of needles?
- B. I have to use a walker because I cant bear any weight on this knee yet.
- C. I will call my health care provider if I get short of breath or sore or swollen below my knee
- D. The raised toilet seat makes it easier for me to get on and off the toilet by myself.
Correct Answer: A
Rationale: Self-administered anticoagulant injections require confirmation of correct technique, not spousal fear, indicating misunderstanding. Walker use , symptom reporting , and toilet aids are correct.
An elderly client is severely dehydrated. Which is the best way to assess the effectiveness of fluid restoration therapy?
- A. Assess the client's skin turgor every shift.
- B. Record weights daily.
- C. Ask the client if she is thirsty.
- D. Record all intake.
Correct Answer: B
Rationale: Daily weights provide an objective measure of fluid restoration, as 1 kg approximates 1 L of fluid. Skin turgor is less reliable in elders, thirst is subjective, and intake alone doesn't confirm absorption.