Nokea
The nurse is caring for a client with chronic obstructive pulmonary disease (COPD).
- A. Which intervention should the nurse include in the care plan for a client with COPD?
- B. Encourage a high-protein, low-carbohydrate diet.
- C. Administer oxygen at 6 liters per minute via nasal cannula.
- D. Teach the client to use pursed-lip breathing.
- E. Place the client in a supine position to promote rest.
Correct Answer: C
Rationale: Pursed-lip breathing prolongs exhalation, reducing air trapping and improving oxygenation in COPD. High-protein diets are beneficial but secondary, high-flow oxygen risks CO2 retention, and supine positioning impairs breathing.
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The mother of a 3 month-old infant tells the nurse that she wants to change from formula to whole milk and add cereal and meats to the diet. What should be emphasized as the nurse teaches about infant nutrition?
- A. Solid foods should be introduced at 3-4 months
- B. Whole milk is difficult for a young infant to digest
- C. Fluoridated tap water should be used to dilute milk
- D. Supplemental apple juice can be used between feedings
Correct Answer: B
Rationale: Cow's milk is not given to infants younger than 1 year because the tough, hard curd is difficult to digest. In addition, it contains little iron and creates a high renal solute load.
The nurse is caring for a client with a history of seizures who is receiving phenytoin (Dilantin) 100 mg PO tid. Which of the following client statements would be of GREATest concern to the nurse?
- A. I brush my teeth twice a day.
- B. I take my medication with milk.
- C. I have a rash on my arms.
- D. I feel drowsy in the morning.
Correct Answer: C
Rationale: A rash may indicate a hypersensitivity reaction to phenytoin, potentially progressing to severe conditions like Stevens-Johnson syndrome, requiring immediate evaluation. Options A, B, and D are less concerning: brushing teeth is routine, milk does not affect absorption, and drowsiness is a common side effect.
Which information should be given to a client taking Dilantin (phenytoin)?
- A. Taking the medication with meals will increase its effectiveness
- B. The medication can cause sleep disturbances
- C. More frequent dental appointments will be needed for special gum care
- D. The medication decreases the effects of oral contraceptives
Correct Answer: C
Rationale: Phenytoin can cause gingival hyperplasia, necessitating more frequent dental visits for gum care.
The nurse is discussing nutritional requirements with the parents of an 18 month-old child. Which of these statements about milk consumption is correct?
- A. May drink as much milk as desired
- B. Can have milk mixed with other foods
- C. Will benefit from fat-free cow's milk
- D. Should be limited to 3-4 cups of milk daily
Correct Answer: D
Rationale: Should be limited to 3-4 cups of milk daily. Excessive milk intake can reduce consumption of other nutrients.
A client is placed on sulfamethoxazole-trimethoprim (Bactrim) for a recurrent urinary tract infection. Which of the following is appropriate reinforcement of information by the nurse?
- A. Drink at least 8 glasses of water a day.
- B. Be sure to take the medication with food.
- C. It is safe to take with oral contraceptives.
- D. Stop the medication after 5 days.
Correct Answer: A
Rationale: Bactrim is a highly insoluble drug and requires a large volume of fluid intake. It is not necessary to take it with food. Options C and D are incorrect instructions for those taking Bactrim.