Nokea
A 52-year-old woman complains of chronic constipation.
The nurse in the health care clinic should advise the woman to
- A. reduce her intake of highly seasoned foods and fats.
- B. drink 1,000 cc of fluids daily.
- C. increase her intake of cereals, fresh fruits, and vegetables.
- D. ask her physician to prescribe Dulcolax 5 mg enteric-coated tablets daily.
Correct Answer: C
Rationale: Strategy: All answers are implementations. Determine the outcome of each answer choice. Is it desired? (1) unnecessary, no effect on constipation (2) normal intake 1,500-2,000, reduced intake causes constipation (3) correct-bulk-forming foods help with constipation (4) passing the buck, laxatives are a last resort
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A client who is terminally ill has been receiving high doses of an opioid analgesic for the past month. As death approaches and the client becomes unresponsive to verbal stimuli, what orders would the nurse expect from the health care provider?
- A. Decrease the analgesic dosage by half
- B. Discontinue the analgesic
- C. Continue the same analgesic dosage
- D. Prescribe a less potent drug
Correct Answer: C
Rationale: Continue the same analgesic dosage. Dying patients who have been in chronic pain will probably continue to experience pain even though they cannot communicate their experience. Pain medication should be continued at the same dose, if effective.
A patient with effective pain relief.
Which of the following nursing actions is MOST important to provide a patient with effective pain relief?
- A. Teach the patient about his pain.
- B. Establish a trusting relationship with the patient.
- C. Determine how various relaxation techniques affect the pain.
- D. Provide alternative measures to relieve pain.
Correct Answer: B
Rationale: Strategy: All answers are implementations. Determine the outcome of each answer choice. Is it desired? (1) not most important (2) correct-necessary to work with patient to identify interventions to relieve pain (3) part of intervention and evaluation phase (4) only a portion of interventions used to relieve pain
A client with right-sided weakness.
The nurse in the outpatient clinic teaches a client with right-sided weakness to walk down stairs using a cane. What behavior, if demonstrated by the client, would indicate that teaching was successful?
- A. The client puts her right leg on the step, then the cane, followed by her left leg.
- B. The client leads with the cane, followed by her right leg, and then her left leg.
- C. The client advances her right leg, followed by her left leg and the cane.
- D. The client puts the cane on the step and advances her left leg, followed by her right leg.
Correct Answer: B
Rationale: Strategy: All answers are implementations. Determine the outcome of each answer choice. Is it desired? (1) to go down stairs, advance weak leg and cane first; to go up stairs, advance strong leg, then weak leg and cane (2) correct-to do down stairs, advance cane and weak leg, then strong leg; memory trick: the good goes up, the bad goes down (3) should advance cane and weak leg first (4) weaker leg and cane advance first
A client asks the home care nurse to look at the bruises on her arms and legs. The woman also tells the nurse that her gums bleed when she uses dental floss or brushes her teeth. The client is taking all of the following medications. Which is most likely related to the client's symptoms?
- A. Metformin (Glucophage)
- B. Estrogen (Premarin)
- C. Atenolol (Tenormin)
- D. Ibuprofen (Motrin)
Correct Answer: D
Rationale: Ibuprofen, an NSAID, can inhibit platelet function, causing bruising and bleeding gums. Other medications are less likely to cause these symptoms.
The nurse is preparing discharge teaching for the parents of a newborn. Which of the following information should the nurse provide to the parents regarding the accuracy of a PKU (phenylketonuria) Test ?
- A. Breast-fed babies need to be a week old for the Test , and infants on formula can be Test ed in three days.
- B. The Test will need to be repeated at six weeks and at the three-month.pnlcheck-up.
- C. Blood will be drawn at three one-hour intervals; there is no specific preparation.
Correct Answer: A
Rationale: formula or cow's milk contains high phenylalanine levels; Test can be done after three days of formula intake; if mother is breastfeeding, infant will need to return in one week for Test