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The nurse is caring for a client with a history of myocardial infarction.
- A. Which instruction is most important for a client post-myocardial infarction?
- B. Avoid heavy lifting for 6 weeks.
- C. Take nitroglycerin only when chest pain occurs.
- D. Resume normal activity immediately.
- E. Monitor blood pressure weekly.
Correct Answer: A
Rationale: Avoiding heavy lifting for 6 weeks prevents cardiac strain during myocardial healing. Nitroglycerin is used for angina, gradual activity resumption is advised, and blood pressure monitoring is routine but secondary.
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The nurse is caring for a client with a history of irritable bowel syndrome.
- A. Which dietary instruction is most appropriate for a client with irritable bowel syndrome?
- B. Avoid caffeine and alcohol.
- C. Eat large, infrequent meals.
- D. Consume a high-fat diet.
- E. Limit fiber intake.
Correct Answer: A
Rationale: Avoiding caffeine and alcohol reduces gut irritation in irritable bowel syndrome. Small, frequent meals, balanced fiber, and low-fat diets are recommended.
The nurse is caring for a client who had a cholecystectomy. Which of the following observations is MOST important for the nurse to report to the next shift?
- A. Resting after receiving IM pain medication.
- B. No bowel sounds present.
- C. IV infusing at 100 cc/h.
- D. Breath sounds decreased in both lower lobes.
Correct Answer: D
Rationale: Decreased breath sounds suggest atelectasis or pneumonia, serious post-cholecystectomy complications due to reduced ventilation from pain. Options A, B, and C are routine: resting is expected, absent bowel sounds are normal post-surgery, and IV rate is standard.
An infant is suspected of having coarctation of the aorta. Which assessment finding is most related to coarctation of the aorta?
- A. Respirations are 70 per minute.
- B. Blood pressure is higher in the upper extremities than in the lower extremities.
- C. There is a heart murmur.
- D. Heart rate is 150 beats per minute.
Correct Answer: B
Rationale: Coarctation of the aorta causes aortic narrowing, leading to higher blood pressure in the upper extremities compared to the lower, a hallmark sign.
The nurse is talking with an adult who says she has chronic constipation. What suggestion would probably be most helpful to the client?
- A. Eat large amounts of rice.
- B. Increase the amount of fruits and vegetables in your diet.
- C. Ask the doctor for a prescription for a drug such as diphenoxylate hydrochloride and atropine sulfate (Lomotil).
- D. Drink fluids only with meals.
Correct Answer: B
Rationale: Fruits and vegetables are high in fiber, promoting bowel regularity and alleviating constipation. Rice is low-fiber, Lomotil slows motility, and limiting fluids to meals can worsen constipation.
The nurse is teaching a client with a new diagnosis of gout about dietary modifications. Which of the following foods should the nurse advise the client to avoid?
- A. Fresh spinach.
- B. Lean chicken breast.
- C. Canned sardines.
- D. Whole-grain pasta.
Correct Answer: C
Rationale: Canned sardines are high in purines, which increase uric acid levels and exacerbate gout. Options A, B, and D are suitable: spinach is low-purine, chicken is lean, and whole-grain pasta is not restricted.