Nokea
The nurse is instructing a client with iron-deficiency anemia. Which of the following meal plans would the nurse expect the client to select?
- A. Roast beef, gelatin salad, green beans, and peach pie
- B. Chicken salad sandwich, coleslaw, French fries, ice cream
- C. Egg salad on wheat bread, carrot sticks, lettuce salad, raisin pie
- D. Pork chop, creamed potatoes, corn, and coconut cake
Correct Answer: A
Rationale: Roast beef is a good source of heme iron, which is more easily absorbed, making this meal plan the best choice for a client with iron-deficiency anemia.
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When preparing a client for admission to the surgical suite, the nurse recognizes that which one of the following items is most important to remove before sending the client to surgery?
- A. Hearing aid
- B. Contact lenses
- C. Wedding ring
- D. Dentures
Correct Answer: B
Rationale: Contact lenses must be removed before surgery to prevent corneal damage or injury under anesthesia, especially if electrocautery is used, which could cause burns if foreign objects are present in the eyes.
A transient homeless client with a history of mental illness and substance abuse is to be discharged. Which of the following support systems are most likely to provide social support for the client? Select all that apply.
- A. Self-help programs.
- B. Internet-based programs.
- C. Community agencies.
- D. Governmental agencies.
- E. Friends.
- F. Family.
Correct Answer: A,C,D
Rationale: Community agencies (C), governmental agencies (D), and self-help programs (A) are likely to provide social support for a homeless client with mental illness and substance abuse. Internet-based programs (B), friends (E), and family (F) may be less accessible or reliable.
The nurse has performed nutritional teaching on a client with gout who is placed on a low-purine diet. Which selection by the client would indicate that teaching has been ineffective?
- A. Cabbage
- B. Apple
- C. Peach cobbler
- D. Spinach
Correct Answer: D
Rationale: Spinach is high in purines, which can exacerbate gout. Cabbage, apples, and peach cobbler (if low in purine ingredients) are suitable for a low-purine diet.
The physician has ordered an infusion of Osmitrol (mannitol) for a client with increased intracranial pressure. Which finding indicates the direct effectiveness of the drug?
- A. Increased pulse rate
- B. Increased urinary output
- C. Decreased diastolic blood pressure
- D. Increased pupil size
Correct Answer: B
Rationale: Mannitol is an osmotic diuretic that reduces intracranial pressure by increasing urinary output, drawing fluid out of the brain tissue.
A pneumonectomy is performed on a client with lung cancer. Which of the following would probably be omitted from the client's plan of care?
- A. Closed chest drainage
- B. Pain-control measures
- C. Supplemental oxygen
- D. Coughing and deep-breathing exercises
Correct Answer: A
Rationale: After a pneumonectomy, the affected lung is removed, and the pleural space fills with fluid naturally, so closed chest drainage is typically not used, unlike in other lung surgeries.