Nokea
The nurse is assessing a client at home who is receiving outpatient hemodialysis 12 hours a week. The nurse knows the client needs further instruction about proper diet when he states which of the following?
- A. I drink prune juice when I'm constipated.
- B. I drink ginger ale with lunch.
- C. I drink 1 cup of milk with my dinner.
- D. My bread choice is white rather than whole grain.
Correct Answer: C
Rationale: Milk is high in phosphorus and potassium, which should be limited in hemodialysis patients to prevent electrolyte imbalances.
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The client is having fetal heart rates of 100-110 beats per minute during the contractions. The first action the nurse should take is to:
- A. Apply an internal monitor
- B. Turn the client to her side
- C. Get the client up and walk her in the hall
- D. Move the client to the delivery room
Correct Answer: B
Rationale: Turning the client to her side improves uteroplacental perfusion, addressing fetal bradycardia during contractions.
The nurse is infusing total parenteral nutrition (TPN) through a peripherally inserted central catheter. The client's TPN was turned off for 1 hour for an MRI. Which action by the nurse is most appropriate for this client?
- A. notify the health care provider for further orders
- B. discard the volume of the TPN that should have been administered and make a note in the chart
- C. double the flow rate on the infusion for 1 hour to keep the TPN on schedule, and then resume the normal flow rate
- D. increase the flow rate on the infusion for two hours to keep the TPN on schedule, and then resume the normal flow rate
Correct Answer: A
Rationale: Notifying the provider ensures proper adjustment of TPN administration, as altering rates or discarding solution can cause metabolic imbalances.
Which information should be reported to the state Board of Nursing?
- A. The facility fails to provide literature in both Spanish and English.
- B. The narcotic count has been incorrect on the unit for the past 3 days.
- C. The client fails to receive an itemized account of his bills and services received during his hospital stay.
- D. The nursing assistant assigned to the client with hepatitis fails to feed the client and give the bath.
Correct Answer: B
Rationale: Incorrect narcotic counts suggest potential diversion or mismanagement of controlled substances, which must be reported to the state Board of Nursing.
Following eruption of the primary teeth, the mother can promote chewing by giving the toddler:
- A. Pieces of hot dog
- B. Carrot sticks
- C. Pieces of cereal
- D. Raisins
Correct Answer: C
Rationale: Cereal pieces are soft, safe, and promote chewing without the choking risk posed by hot dogs, carrots, or sticky raisins in toddlers.
The nurse has just admitted a client with emphysema. Arterial blood gas results indicate hypoxia. Which physician prescription would the nurse implement for the best improvement in the client's hypoxia?
- A. Elevate the head of the bed 45°
- B. Encourage diaphragmatic breathing
- C. Initiate an Alupent nebulizer treatment
- D. Start Oâ‚‚ at 2 L/min
Correct Answer: D
Rationale: Low-flow oxygen (2 L/min) directly addresses hypoxia in emphysema by improving arterial oxygen levels, making it the most effective intervention.