Nokea
The nurse is planning dietary changes for a client following an episode of acute pancreatitis. Which diet is suitable for the client?
- A. Low calorie, low carbohydrate
- B. High calorie, low fat
- C. High protein, high fat
- D. Low protein, high carbohydrate
Correct Answer: B
Rationale: A high-calorie, low-fat diet is suitable post-acute pancreatitis to support recovery while minimizing pancreatic stimulation.
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The nurse is caring for a client following a crushing injury to the chest. Which finding would be most indicative of a tension pneumothorax?
- A. Frothy hemoptysis
- B. Trachea shift toward the unaffected side of the chest
- C. Subcutaneous emphysema noted at the anterior chest
- D. Opening chest wound with a whistle sound emitting from the area
Correct Answer: B
Rationale: Tension pneumothorax causes a mediastinal shift, including tracheal deviation toward the unaffected side due to increased intrathoracic pressure.
The nurse is assessing the reflexes of a full-term newborn infant. Which of the following is true regarding newborn reflexes?
- A. The Babinski reflex disappears after 1 year of age.
- B. Complete fencing response disappears by 2 months.
- C. The stepping or 'walking' reflex is present until 3-4 months.
- D. The Moro reflex is present at birth and disappears by 6 months.
Correct Answer: D
Rationale: The Moro reflex, present at birth, typically disappears by 6 months. Babinski persists until ~2 years, fencing (tonic neck) until 4-6 months, and stepping until 1-2 months.
The 5-year-old is being tested for enterobiasis (pinworms). To collect a specimen for assessment of pinworms, the nurse should teach the mother to:
- A. Place tape on the child's perianal area before putting the child to bed
- B. Scrape the skin with a piece of cardboard and bring it to the clinic
- C. Obtain a stool specimen in the afternoon
- D. Bring a hair sample to the clinic for evaluation
Correct Answer: A
Rationale: The tape test, applied to the perianal area at night or early morning, is the standard method to collect pinworm eggs.
The physician has ordered 50 mEq of potassium chloride for a client with a potassium level of 2.5 mEq. The nurse should administer the medication:
- A. Slow, continuous IV push over 10 minutes
- B. Continuous infusion over 30 minutes
- C. Controlled infusion over 5 hours
- D. Continuous infusion over 24 hours
Correct Answer: C
Rationale: Potassium chloride should be administered slowly (e.g., over 5 hours for 50 mEq) to prevent cardiac complications, as rapid infusion can cause hyperkalemia.
Which statement is incorrect regarding the Federal Nursing Home Reform Act from the Omnibus Budget Reconciliation Act of 1987 (OBRA '87)?
- A. the right to be free of unnecessary chemical restraints
- B. the right to choose a personal physician
- C. the right to access medical records
- D. the right to organize hospital personnel within a union
Correct Answer: D
Rationale: OBRA '87 does not include the right to organize hospital personnel into a union. Other rights are part of the act.