Nokea
The nurse is caring for a client with a history of gastric bypass surgery. Which of the following vitamins is the client at highest risk for deficiency?
- A. Vitamin A.
- B. Vitamin B12.
- C. Vitamin C.
- D. Vitamin D.
Correct Answer: B
Rationale: Gastric bypass surgery impairs vitamin B12 absorption due to reduced intrinsic factor production, increasing deficiency risk.
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A client with a history of chronic obstructive pulmonary disease (COPD) is prescribed tiotropium (Spiriva). The nurse should instruct the client to:
- A. Use the inhaler as needed for shortness of breath.
- B. Rinse the mouth after inhalation.
- C. Take the inhaler with meals.
- D. Stop the inhaler if dizziness occurs.
Correct Answer: B
Rationale: Rinsing the mouth after tiotropium inhalation prevents oral thrush.
A 13-year-old client is dying of cancer and struggling with the emotional aspects of this. When providing care for this client, the nurse should incorporate the developmental tasks for this age. According to Erikson's developmental model, the child normally is expected to be working on which of the following psychosocial issues?
- A. Identity vs. role confusion.
- B. Intimacy vs. isolation.
- C. Industry vs. inferiority.
- D. Autonomy vs. shame and doubt.
Correct Answer: A
Rationale: Adolescents (ages 12–18) focus on identity vs. role confusion, developing a sense of self and personal identity.
Pelvic inflammatory disease is most often caused by:
- A. Trichomoniasis
- B. E. coli
- C. Staphylococcus aureus
- D. Neisseria gonorrhoeae
Correct Answer: D
Rationale: Neisseria gonorrhoeae is a common cause of pelvic inflammatory disease, often resulting from untreated gonorrhea, leading to infection of the reproductive organs.
Which lipid level would you report to the doctor because it is not normal and it is also a significant change in the client?
- A. Triglycerides: 75 mg/dL
- B. Total cholesterol: 6.5 mmol/L
- C. High-density lipoprotein (HDL): 60 mg/dL
- D. Low-density lipoprotein (LDL): 955 mg/dL
Correct Answer: D
Rationale: LDL of 955 mg/dL is extremely high (normal <130 mg/dL), indicating a significant risk for cardiovascular disease and requiring immediate reporting.
A client with a diagnosis of hyperthyroidism is prescribed propylthiouracil (PTU). The nurse should monitor the client for which of the following side effects?
- A. Weight gain.
- B. Agranulocytosis.
- C. Hypertension.
- D. Hyperglycemia.
Correct Answer: B
Rationale: Propylthiouracil can cause agranulocytosis, requiring monitoring of white blood cell counts.