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The nurse is providing dietary instructions for a client who is being discharged after passing a calcium oxalate renal stone. Which food should the nurse instruct the client to avoid?
- A. Sweet potatoes.
- B. Spinach salad.
- C. Bananas.
- D. Fish.
Correct Answer: B
Rationale: Spinach salad is high in oxalate, which can combine with calcium in the urine to form stones, increasing the risk of recurrence.
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Five months following treatment for Herpes zoster (shingles), an older adult client tells the home health nurse of continuing to experience pain where the rash occurred. Which action should the nurse implement?
- A. Perform a complete mental status exam.
- B. Determine if the client has had a shingles vaccination.
- C. Teach the client about phantom pain symptoms.
- D. Complete an assessment of the client's pain.
Correct Answer: D
Rationale: Completing a pain assessment is the most important action to identify the cause, severity, and impact of the pain, likely postherpetic neuralgia, to plan appropriate interventions.
While completing a health assessment for a young adult female with acute appendicitis, the client informs the nurse that there is a chance that she may be pregnant. The operating team is preparing to take the client to surgery. Which intervention should the nurse implement immediately?
- A. Perform a bedside pregnancy test.
- B. Continue with surgery as scheduled.
- C. Calculate gestation from last menstrual cycle.
- D. Notify the surgical team to cancel the surgery.
Correct Answer: A
Rationale: Performing a bedside pregnancy test is critical to confirm or rule out pregnancy, as surgery could pose risks to the fetus, informing the surgical team's approach.
An older adult client with symptoms of osteoarthritis asks the nurse which form of exercise would be most beneficial. Which is the best response by the nurse?
- A. Jogging or running are excellent aerobic exercises.
- B. Tennis or racquetball will increase your muscle strength.
- C. Limit your exercise to just your daily activities.
- D. Swimming is an excellent exercise for you.
Correct Answer: D
Rationale: Swimming is a low-impact aerobic exercise that strengthens muscles, improves cardiovascular fitness, and enhances joint flexibility without putting stress on joints, making it ideal for osteoarthritis.
A client with type 1 diabetes mellitus, hypertension, and chronic kidney disease is to begin hemodialysis treatment. Which statement should the nurse include in client education?
- A. Prepare for an abdominal catheter.
- B. Continue routine medications.
- C. Expect the insulin dosage to be reduced.
- D. Include potassium-rich foods in the diet.
Correct Answer: C
Rationale: Insulin dosage may need to be reduced during hemodialysis because insulin is removed by the dialyzer and blood glucose levels may drop. This is the correct statement to include in client education.
A client with acquired immune deficiency syndrome (AIDS) and Pneumocystis jiroveci pneumonia has a CD4+ T cell count of 200 cells/mm³ (20%). The client asks the nurse why they have these recurring massive infections. Which pathophysiological mechanism should the nurse describe in response to this client's question?
- A. The humoral immune response lacks B cells that form antibodies and opportunistic infections result.
- B. Inadequate numbers of T lymphocytes are available to initiate cellular immunity and macrophages.
- C. Bone marrow suppression of white blood cells causes insufficient cells to phagocytize organisms.
- D. Exposure to multiple environmental infectious agents overburdens the immune system until it fails.
Correct Answer: B
Rationale: Inadequate numbers of CD4+ T cells impair cellular immunity, making the client susceptible to opportunistic infections like Pneumocystis jiroveci pneumonia due to HIV infection.