Nokea
The nurse is conducting a community group discussion on nutrition. One of the participants says to the nurse, 'I am a vegan. I have been told I might get pernicious anemia. How can I prevent that?' What should the nurse include when answering the client?
- A. She is not at risk for pernicious anemia because there are many nonmeat sources of vitamin B12.
- B. She is at risk of developing pernicious anemia, but taking a vitamin supplement that contains vitamin B12 should prevent it.
- C. She should see her physician and ask about getting monthly injections of vitamin B12 because she is a risk for pernicious anemia.
- D. She should be tested for an enzyme that produces vitamin B12. If she is deficient, she should be treated with daily injections.
Correct Answer: B
Rationale: Vegans lack dietary B12 (found in animal products), risking pernicious anemia. Oral B12 supplements can prevent deficiency, while injections or enzyme testing are unnecessary unless absorption issues exist.
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A client taking isoniazid (INH) for tuberculosis asks the nurse about side effects of the medication. The client should be instructed to immediately report which of these?
- A. Double vision and visual halos
- B. Extremity tingling and numbness
- C. Confusion and lightheadedness
- D. Sensitivity of sunlight
Correct Answer: B
Rationale: Extremity tingling and numbness. Peripheral neuropathy is the most common side effect of INH and should be reported to the provider. It can be reversed.
The nurse is caring for a client who is postoperative day 1 after a coronary artery bypass graft (CABG). Which of the following findings would be of GREATest concern to the nurse?
- A. Heart rate of 100 bpm.
- B. Temperature of 100.8°F (38.2°C).
- C. Chest tube drainage of 150 mL/hour.
- D. Blood pressure of 130/80 mmHg.
Correct Answer: C
Rationale: Chest tube drainage of 150 mL/hour is excessive post-CABG, suggesting hemorrhage, requiring immediate evaluation. Options A, B, and D are less concerning: heart rate 100 bpm and temperature 100.8°F are common, and blood pressure 130/80 mmHg is normal.
The nurse is caring for a client with a fractured femur in traction.
- A. What is the most appropriate action for the nurse if the client reports numbness in the affected leg?
- B. Reposition the traction weights.
- C. Check the pin sites for infection.
- D. Assess the neurovascular status of the leg.
- E. Administer pain medication as ordered.
Correct Answer: C
Rationale: Numbness in the affected leg suggests possible neurovascular compromise, requiring immediate assessment of circulation, sensation, and motor function. Adjusting traction, checking pin sites, or giving pain medication does not address the urgent need to evaluate neurovascular status.
A man who had a cerebrovascular accident has expressive aphasia. Which approach will help communication the most?
- A. The nurse should write to the client and the client should write back.
- B. The nurse should anticipate the client's needs as much as possible.
- C. The nurse should encourage the client to speak as much as possible.
- D. A family member should stay with the client and express the client's needs to the nurse.
Correct Answer: C
Rationale: Encouraging speech practice aids communication recovery in expressive aphasia, fostering independence. Writing, anticipating needs, or relying on family are less effective.
The nurse is caring for a client who has dentures. Which action by the nurse is not appropriate?
- A. Place a washcloth in the bottom of the sink before cleaning the dentures.
- B. Brush the dentures with toothpaste.
- C. Rinse the dentures with hydrogen peroxide.
- D. Remove the dentures from the mouth for cleaning.
Correct Answer: C
Rationale: Hydrogen peroxide can damage dentures; rinsing with water or denture cleaner is appropriate, making this action incorrect.