Nokea
The nurse is planning care for the patient with celiac disease. In teaching about the diet, the nurse should instruct the patient to avoid which of the following for breakfast?
- A. Puffed wheat
- B. Banana
- C. Puffed rice
- D. Cornflakes
Correct Answer: A
Rationale: Puffed wheat contains gluten, which must be avoided in celiac disease to prevent intestinal damage.
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A client with cancer received platelet infusions 24 hours ago. Which of the following assessment findings would indicate the most therapeutic effect from the transfusions?
- A. Hgb level increase from 8.9 to 10.6
- B. Temperature reading of 99.4°F
- C. White blood cell count of 11,000
- D. Decrease in oozing of blood from IV site
Correct Answer: D
Rationale: Platelet infusions aim to improve clotting. Decreased oozing from an IV site indicates effective platelet function. The other findings are unrelated to platelets.
A client on a 72-hour psychiatric hold experiences a panic attack while getting ready for the day. The nurse should provide the following interventions ranked by priority:
- A. stay with the client until the panic attack is over
- B. incorporate physical activity into the client's daily routine
- C. instruct the client to take slow, deep breaths
- D. reduce external stimuli in the immediate area
- E. work with the client to develop coping mechanisms
Correct Answer: A,D,C,E,B
Rationale: Priority order: Stay with the client (A) for safety, reduce stimuli (D) to calm the environment, instruct deep breathing (C) to manage symptoms, develop coping mechanisms (E) for future prevention, and incorporate physical activity (B) as a long-term strategy.
A client with a T5 spinal cord injury suddenly begins sweating profusely in the face and neck. Vital signs reveal sudden bradycardia and significant increase in blood pressure. Which is the priority nursing action?
- A. administer nitrate or nifedipine
- B. check the client for fecal impaction
- C. check the client for bladder distention
- D. place the bed in high Fowler's position
Correct Answer: C
Rationale: These symptoms indicate autonomic dysreflexia, often triggered by bladder distention in spinal cord injuries above T6. Checking and relieving bladder distention is the priority.
The nurse is preparing to discharge a client diagnosed with gout. Which statement by the client indicates understanding of dietary restrictions while managing gout?
- A. I should avoid beer, anchovies, and liver.
- B. I should avoid bananas, grapefruit, and oranges.
- C. I should avoid dairy products such as milk and ice cream.
- D. I should avoid red wine, dark chocolate, and aged cheeses.
Correct Answer: A
Rationale: Beer, anchovies, and liver are high in purines, which can exacerbate gout, making avoidance appropriate.
The nurse is performing discharge teaching to a client newly diagnosed with hypertension and high cholesterol. Which statement by the client indicates that the nurse's teaching was effective?
- A. I need to buy canned foods that are low in sodium.
- B. I can substitute lean sirloin for my homemade fried chicken.
- C. I will take a can of soup to work for lunch instead of eating a burger.
- D. Frozen dinners are better for me than eating in the cafeteria at work.
Correct Answer: B
Rationale: Substituting lean sirloin for fried chicken reduces fat and cholesterol. Canned foods, soups, and frozen dinners are often high in sodium, unsuitable for hypertension.