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The nurse is providing home care dietary instructions to a client who has been hospitalized for pancreatitis. Which food should the nurse instruct the client to avoid to prevent recurrence?
- A. Chili
- B. Bagels
- C. Lentil soup
- D. Watermelon
Correct Answer: A
Rationale: Pancreatitis involves inflammation of the pancreas, and spicy foods like chili can stimulate pancreatic secretions, potentially triggering a recurrence. The client should eat small, frequent meals that are high in protein, low in fat, and moderate to high in carbohydrates. Bagels, lentil soup, and watermelon are generally bland and acceptable.
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The nurse is caring for a client who is scheduled to have a thyroidectomy and provides instructions to the client about the surgical procedure. Which statement by the client indicates an understanding of the nurse's instructions?
- A. I will definitely have to continue taking antithyroid medication after this surgery.
- B. I need to place my hands behind my neck when I have to cough or change positions.
- C. I need to turn my head and neck front, back, and side to side every hour for the first 12 hours after surgery.
- D. I will immediately report to the emergency room if I experience tingling of my toes, fingers, and lips after surgery.
Correct Answer: B
Rationale: One way of reducing incisional tension is to teach the client how to support the neck when coughing or being repositioned. The removal of the thyroid does not mean that the client will be taking antithyroid medications postoperatively. The client is taught that after thyroidectomy tension needs to be avoided on the suture line because hemorrhage may develop. Likewise, during the postoperative period, the client should avoid any unnecessary movement of the neck; that is why sandbags and pillows are frequently used to support the head and neck. If a client experiences tingling in the fingers, toes, and lips, it is probably a result of injury to the parathyroid gland during surgery, resulting in hypocalcemia. These signs and symptoms need to be reported immediately.
The nurse teaches a client with hypertension to recognize the signs/symptoms that may occur during periods of elevated blood pressure. The nurse determines that the client needs additional teaching if the client states that which sign/symptom is associated with this condition?
- A. Epistaxis
- B. Dizziness
- C. Blurred vision
- D. A feeling of fullness in the head
Correct Answer: D
Rationale: A feeling of fullness in the head is more likely associated with a sinus condition than hypertension. Cerebrovascular symptoms of hypertension include early morning headaches, occipital headaches, epistaxis, dizziness, blurred vision, lightheadedness, and vertigo. The client should be aware of these signs/symptoms and report them if they occur. The client should also be taught to self-monitor the blood pressure.
The nurse provides dietary instruction to the parents of a child with a diagnosis of cystic fibrosis. The nurse should tell the parents that which diet plan should be followed?
- A. Fat free
- B. Low in protein
- C. Low in sodium
- D. High in calories
Correct Answer: D
Rationale: Children with cystic fibrosis are managed with a high-calorie, highprotein diet; pancreatic enzyme replacement therapy; fat-soluble vitamin supplements; and if nutritional problems are severe, nighttime gastrostomy feedings or parental nutrition. Fats are not restricted unless steatorrhea cannot be controlled by increased pancreatic enzymes. Sodium intake is unrelated to this disorder.
The nurse assesses cranial nerve XII in the client who sustained a stroke. Which action should the nurse ask the client to perform?
- A. Extend the arms.
- B. Extend the tongue.
- C. Turn the head toward the nurse's arm.
- D. Focus the eyes on an object held by the nurse.
Correct Answer: B
Rationale: Cranial nerve XII (hypoglossal) controls tongue movement, so extending the tongue tests its function. Other actions test different nerves or motor functions, not relevant to cranial nerve XII.
A mother brings her 6-month-old child to the clinic for a wellness checkup. The nurse anticipates that the health care provider will order which vaccinations for this client?
- A. DTaP and MMR
- B. Hib and varicella
- C. hepatitis B and DTaP
- D. hepatitis A and MMR
Correct Answer: C
Rationale: At 6 months, hepatitis B and DTaP are scheduled. MMR, varicella, and hepatitis A are given later (12-15 months).