Nokea
The nurse is caring for a 78-year-old male with lung cancer who is receiving chemotherapy. The client states he is not eating well but otherwise feels healthy. Which meal suggestion would be best for this client?
- A. Local health milk and strawberries.
- B. Toast, gelatin dessert, and cookies.
- C. Broiled chicken, green beans, and cottage cheese.
- D. Steak and french fries.
Correct Answer: C
Rationale: Broiled chicken, green beans, and cottage cheese provide high protein and nutrients with low fat, which is ideal for a client with poor appetite during chemotherapy to support nutrition without being heavy.
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A client with a spinal cord injury who has been active in sports and outdoor activities talks almost obsessively about his past activities. In tears, one day he asks the nurse, 'Why can't I stop talking about these things? I know those days are gone forever.' Which of the following responses by the nurse conveys the best understanding of the client's behavior?
- A. Be patient. It takes time to adjust to such a massive loss.'
- B. I will be sure to tell the team that reviewing the past is a form of denial. We have to help you focus on today.'
- C. Reviewing your losses is a way to help you work through your grief and loss.'
- D. It's a simple escape mechanism to go back and live again in happier times.'
Correct Answer: C
Rationale: Reflecting on past activities is part of grieving, helping the client process the loss of function.
The nurse is planning care for a client with a femoral fracture who is in balanced suspension traction. Which of the following would the nurse be least likely to include in the plan of care?
- A. Use of a fracture bedpan.
- B. Checks for redness over the ischial tuberosity.
- C. Elevation of the head of bed no more than 25 degrees.
- D. Personal hygiene with a complete bed bath.
Correct Answer: C
Rationale: Elevating the head of the bed beyond 25 degrees can disrupt traction alignment, making it least appropriate.
The nurse is caring for a client who is receiving prescribed aspirin. Which of the following findings would indicate the client is having an adverse effect?
- A. Polyuria
- B. Hypokalemia
- C. Venous thromboembolism
- D. Black, tarry stools
Correct Answer: D
Rationale: Black, tarry stools indicate gastrointestinal bleeding, a serious adverse effect of aspirin due to its antiplatelet and irritant properties.
The nurse transfers a client who received fentanyl 50 mcg IV push 10 minutes ago from the bed to a chair when the client becomes dizzy and falls into the chair. Which of the following actions would be appropriate for the nurse to take?
- A. Administer prescribed naloxone
- B. Assist the client back to bed
- C. Call a code blue
- D. Assess the client's vital signs
Correct Answer: B
Rationale: Dizziness after fentanyl administration suggests orthostatic hypotension; assisting the client back to bed ensures safety.
The emergency department (ED) nurse cares for a client receiving prescribed warfarin and reports dizziness, black tarry stools, and bloody gums. The international normalized ratio (INR) returns at 5 (0.9-1.2 seconds). The nurse anticipates the primary healthcare provider (PHCP) will prescribe which blood product?
- A. Packed red blood cells (PRBCs)
- B. Platelets
- C. Granulocytes
- D. Fresh frozen plasma (FFP)
Correct Answer: D
Rationale: An INR of 5 indicates significant anticoagulation from warfarin, increasing bleeding risk (evidenced by tarry stools and bloody gums). FFP provides clotting factors to reverse warfarin’s effects. PRBCs address anemia, platelets address thrombocytopenia, and granulocytes treat infections, none of which are primary here.