Nokea
The nurse is conducting a health screening on a client with a family history of hypertension. Which assessment finding should alert the nurse to the need for further teaching related to stroke (brain attack) prevention?
- A. Eats two bowls of high-fiber grain cereal with skim milk for breakfast
- B. Has a blood pressure of 118/78 mm Hg and has lost 10 pounds recently
- C. Uses condoms for pregnancy and disease prevention and jogs 2 miles daily
- D. Uses oral contraceptives for pregnancy prevention and works as a manager of a busy medical-surgical unit
Correct Answer: D
Rationale: Oral contraceptives increase clot formation risk, a modifiable stroke risk factor, especially with a hypertension family history. High-fiber diet, normal blood pressure, weight loss, and exercise (options A, B, C) reduce stroke risk.
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The nurse prepares a client with a peripheral intravenous (IV) site for home IV therapy for discharge. Which should the nurse teach the client to help prevent phlebitis and infiltration?
- A. Massage the IV site daily.
- B. Immobilize the extremity.
- C. Stabilize the cannula with tape.
- D. Cleanse the site daily with alcohol.
Correct Answer: C
Rationale: Stabilizing the cannula with tape prevents movement, reducing the risk of phlebitis and infiltration. Massaging the site can cause tissue damage, immobilizing the extremity is unnecessary, and alcohol cleansing causes skin drying and discomfort.
The nurse is educating a client who is 10 weeks pregnant about prenatal nutrition. The client is of normal weight. Which statement by the client indicates an understanding of weight gain during pregnancy?
- A. I should gain 15 to 20 pounds.
- B. I should gain 25 to 35 pounds.
- C. I should gain 35 to 40 pounds.
- D. I should gain 40 to 45 pounds.
Correct Answer: B
Rationale: Normal-weight women should gain 25-35 pounds during pregnancy, as per guidelines.
The school nurse provides teaching about the hazards of smoking to a group of high school students. Which comment by a student indicates the need for additional teaching?
- A. Chewing tobacco is much safer than is smoking tobacco.
- B. Smoking during pregnancy increases the risk of stillbirth.
- C. My health is at risk when my family smokes in the house.
- D. Inhaling smoke from other people is a public health issue.
Correct Answer: A
Rationale: All forms of tobacco use, including chewing tobacco, are health hazards. Smoking during pregnancy, smoking in a household, and second-hand smoke all present health hazards of tobacco use. Chewing tobacco is not safer than smoking and can lead to oral cancer and other health issues.
The nurse has provided home-care instructions to a client who is taking lithium carbonate. Which client statement indicates that the client understands the prescribed regimen?
- A. I will restrict my water intake.
- B. I will make sure that my diet contains salt.
- C. I will keep my medication in the refrigerator.
- D. I will be careful to avoid eating foods high in potassium.
Correct Answer: B
Rationale: Lithium is a mood stabilizer used to treat bipolar disorder. It replaces sodium ions in the cells and induces the excretion of sodium and potassium from the body. Client teaching includes the maintenance of sodium intake in the daily diet and increased fluid intake (at least 1 to 1½ L per day) during maintenance therapy. Lithium is stored at room temperature and protected from light and moisture.
A client diagnosed with gastritis asks the nurse at a screening clinic about analgesics that will not cause epigastric distress. The nurse should tell the client to take which medication?
- A. Aspirin
- B. Naproxen
- C. Ibuprofen
- D. Acetaminophen
Correct Answer: D
Rationale: The client should be advised to take analgesics that do not contain aspirin, such as acetaminophen. Aspirin is irritating to the gastrointestinal tract of the client with a history of gastritis. Other medications that are irritating to the gastrointestinal tract are the nonsteroidal antiinflammatory drugs naproxen and ibuprofen.