Nokea
The nurse is caring for a client with a history of osteoarthritis. Which of the following non-pharmacologic interventions should be included in the plan of care?
- A. Apply heat to affected joints.
- B. Restrict weight-bearing activities.
- C. Encourage a low-protein diet.
- D. Limit range-of-motion exercises.
Correct Answer: A
Rationale: Heat therapy reduces stiffness and pain in osteoarthritis.
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A client with the diagnosis of leukemia is receiving chemotherapy. When the registered nurse (RN) notes that the white blood cell (WBC) count is 4000 mm^3 (4 x 10^9/L), the new nurse caring for the client is informed about the results. Which intervention identified by the new nurse indicates a need for further teaching?
- A. Restricting visitors with colds or respiratory infections
- B. Removing all live plants, flowers, and stuffed animals in the client's room
- C. Placing the client on a low-bacteria diet that excludes raw foods and vegetables
- D. Padding the side rails and removing all hazardous and sharp objects from the room
Correct Answer: D
Rationale: Padding the side rails and removing all hazardous and sharp objects from the environment would be instituted if the client is at risk for bleeding. This client is at risk for infection. When the WBC count is less than 5000 mm^3 (5 x 10^9/L), visitors should be screened for the presence of infection, and any visitors or staff with colds or respiratory infections should not be allowed in the client's room. All live plants, flowers, and stuffed animals are removed from the client's room. The client is placed on a low-bacteria diet that excludes raw fruits and vegetables.
Your client has a tube feeding. Which of the following commonly occurring complications of tube feedings can you prevent with the preventive measure that is coupled with it?
- A. Constipation: The provision of a high fiber diet
- B. Urinary pH changes: Encouraging ample oral fluid intake
- C. Aspiration: Maintaining the client in at least a 30 degree angle
- D. Aspiration: Maintaining the client in at least a 90 degree angle
Correct Answer: C
Rationale: Maintaining a 30-45 degree angle during tube feedings reduces the risk of aspiration by preventing reflux of gastric contents.
The nurse is auscultating the lung sounds of a client with long-standing emphysema. The nurse should determine if the client has?
- A. Fine crackles
- B. Diminished breath sounds
- C. Stridor
- D. Pleural friction rub
Correct Answer: B
Rationale: Diminished breath sounds are typical in emphysema due to air trapping and reduced airflow. Crackles, stridor, and pleural friction rubs are associated with other conditions.
An infant is at risk for an ileus after surgery to correct intussusception. Which observation should the nurse not include in an assessment for this complication?
- A. Measurement of urine specific gravity.
- B. Assessment of bowel sounds.
- C. Characteristics of the first stool.
- D. Measurement of gastric output.
Correct Answer: A
Rationale: Urine specific gravity is unrelated to assessing for ileus, which involves monitoring bowel sounds, stool characteristics, and gastric output to detect gastrointestinal function.
You are caring for a postoperative client who is complaining of abdominal distention and flatus. Which intervention would you most likely do for this client?
- A. A cleansing enema
- B. A retention enema
- C. A return-flow enema
- D. A laxative
Correct Answer: C
Rationale: A return-flow enema is used to relieve gas and distention by introducing and withdrawing fluid to stimulate gas expulsion.