Nokea
The nurse is caring for a client at 21 weeks gestation with reports of occasional, bothersome heartburn (pyrosis). Which of the following lifestyle changes should the nurse recommend? Select all that apply.
- A. Avoid intake of dairy products
- B. Drink large amounts of fluid with meals
- C. Eat several small meals each day
- D. Eliminate fried, fatty foods
- E. Lie down on the left side after meals
Correct Answer: C,D
Rationale: Small, frequent meals reduce stomach acid reflux, and avoiding fatty foods decreases acid production. Dairy can neutralize acid, large fluid intake with meals distends the stomach, and lying down post-meal worsens reflux.
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Because a client has Addison's disease, the nurse would expect to see which of the following in the nursing assessment?
- A. A supraclavicular fat pad
- B. A puffy face
- C. Low blood pressure
- D. Ecchymotic areas
Correct Answer: C
Rationale: Addison's disease causes cortisol and aldosterone deficiency, leading to hypotension. Fat pads and puffy face are Cushing's symptoms, and ecchymosis is less specific.
The nurse is caring for a client at 15 weeks gestation who has hyperemesis gravidarum. Which of the following findings would be consistent with the condition?
- A. heart rate less than 60/min
- B. moderate to high urine ketones
- C. increased serum potassium level
- D. blood pressure greater than 140/90 mm Hg
Correct Answer: B
Rationale: Hyperemesis gravidarum causes severe vomiting, leading to ketosis (moderate to high urine ketones) from fat breakdown. Bradycardia, hyperkalemia, and hypertension are not typical; tachycardia and hypokalemia may occur.
Medication administration record
Allergies: No Known Allergies
Sliding scale blood glucose levels, regular insulin dose
<150 mg/dL (<8.3 mmol/L), O units
150-199 mg/dL (8.3-11.0 mmol/L), 2 units
200-249 mg/dL (11.1-13.8 mmoV/L), 4 units
250-299 mg/dL (13.9-16.6 mmol/L), 6 units
≥300 mg/dL (≥16.7 mmol/L), 8 units and notify health care provider
A client with type 1 diabetes has a prescription for 30 units of insulin glargine at bedtime. Fingerstick blood glucose measurements are prescribed before meals and at bedtime with regular insulin based on a sliding scale. At 9 PM, the client's blood glucose measurement is 180 mg/dL (10.0 mmol/L). What action should the nurse take?
- A. Administer 30 units of glargine; give the client a snack, then administer 2 units of regular insulin
- B. Administer 30 units of glargine and 2 units of regular insulin in 2 different injections
- C. Mix 30 units of glargine with 2 units of regular insulin in the same syringe, drawing up the glargine first
- D. Mix 30 units of glargine with 2 units of regular insulin in the same syringe, drawing up the regular insulin first
Correct Answer: B
Rationale: The sliding scale indicates 2 units of regular insulin for a glucose of 180 mg/dL. Glargine, a long-acting insulin, should be given as prescribed (30 units). Glargine cannot be mixed with regular insulin in the same syringe due to differing pH levels, so separate injections are required.
A client diagnosed with trigeminal neuralgia is given a prescription of carbamazepine by the health care provider. Which intervention does the nurse anticipate in this client's care plan?
- A. Encourage client to drink cold beverages
- B. Encourage client to eat a high-fiber diet
- C. Encourage client to perform facial massage
- D. Encourage client to report any fever or sore throat
Correct Answer: D
Rationale: Carbamazepine can cause agranulocytosis or infections; fever or sore throat must be reported. Cold beverages may trigger trigeminal neuralgia pain. High-fiber diets and facial massage are unrelated to management.
The nurse is reinforcing teaching about ulcer prevention with a client newly diagnosed with peptic ulcer disease. Which of the following client statements indicate appropriate understanding of teaching? Select all that apply.
- A. I need to avoid taking medicines like ibuprofen without a prescription.
- B. I should avoid drinking excess coffee or cola.
- C. I should enroll in a smoking cessation program.
- D. I should reduce or eliminate my intake of alcoholic beverages.
- E. I will eliminate whole wheat foods, like breads and cereals, from my diet.
Correct Answer: A,B,C,D
Rationale: Avoiding NSAIDs (ibuprofen), excess coffee/cola, smoking, and alcohol reduces ulcer irritation and promotes healing. Whole wheat foods are beneficial for digestion and not contraindicated.