Nokea
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 exacerbate gout. Other foods listed are not primary triggers.
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The nurse is taking a history from a client in an outpatient clinic. The client has been taking duloxetine (Cymbalta) for fibromyalgia. Which of the following over-the-counter medications would cause the nurse some concern if the client says she is taking it?
- A. aspirin
- B. garlic supplements
- C. vitamin B6
- D. cough medicine with dextromethorphan
Correct Answer: D
Rationale: Dextromethorphan can interact with duloxetine, increasing the risk of serotonin syndrome, a potentially serious condition.
A client is admitted to the unit 2 hours after an injury with second-degree burns to the face, trunk, and head. The nurse would be most concerned with the client developing what?
- A. Hypovolemia
- B. Laryngeal edema
- C. Hypernatremia
- D. Hyperkalemia
Correct Answer: B
Rationale: Laryngeal edema is a critical concern with facial and head burns due to the risk of airway obstruction.
A nurse is floated to oncology from the postsurgical floor. The assigned client is almost finished with an infusion of doxorubicin for breast cancer. The floated nurse is not chemotherapy certified. Which nursing action is the priority in this situation?
- A. assess the client's pain
- B. ask another nurse about side effects of the drug
- C. assess the IV site, including the date on the tubing and IV site
- D. inform the charge nurse that she is not chemotherapy certified and ask for another assignment
Correct Answer: D
Rationale: The priority is to inform the charge nurse of the lack of chemotherapy certification, as doxorubicin requires specialized handling and monitoring.
The nurse is completing admission on a client with possible esophageal cancer. Which finding would not be common for this diagnosis?
- A. Foul breath
- B. Dysphagia
- C. Diarrhea
- D. Chronic hiccups
Correct Answer: C
Rationale: Esophageal cancer commonly presents with dysphagia, foul breath (due to tumor necrosis), and chronic hiccups (from diaphragmatic irritation). Diarrhea is not typically associated with esophageal cancer.
The nurse is formulating a plan of care for a client with a goiter. The priority nursing diagnosis for the client with a goiter is:
- A. Body image disturbance related to swelling of neck
- B. Anxiety-related changes in body image
- C. Altered nutrition, less than body requirements, related to difficulty in swallowing
- D. Risk for ineffective airway clearance related to pressure on the trachea
Correct Answer: D
Rationale: A goiter can compress the trachea, posing a risk for airway obstruction, making ineffective airway clearance the priority nursing diagnosis.