Nokea
The nurse is providing instructions to a client and family regarding home care after left-eye cataract removal. The nurse tells the client and family about assuming which position during the postoperative period?
- A. Sleep only on the left side.
- B. Sleep on the right side or the back.
- C. Bend below the waist as often as you are able.
- D. Lower the head between the knees three times a day.
Correct Answer: B
Rationale: After cataract surgery, the client is informed to sleep on the nonoperative side or his or her back. The client should not sleep on the operative side to prevent the development of edema. The client should also avoid bending below the level of the waist or lowering the head because these actions will increase intraocular pressure.
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The nurse determines that the client with gastroesophageal reflux disease (GERD) needs further teaching regarding diet if which statement is made?
- A. I need to avoid coffee, tea, and chocolate.
- B. I should eat four to six small meals a day.
- C. It is important that I drink extra fluids during meals.
- D. I need to avoid snacking for 2 to 3 hours before bedtime.
Correct Answer: C
Rationale: Gastroesophageal reflux disease (GERD) is the backflow of gastric and duodenal contents into the esophagus. Fluids must be taken between meals rather than with meals to prevent the overdistention that leads to reflux. Coffee, tea, cola, and chocolate are eliminated from the diet because they decrease lower esophageal sphincter pressure and can potentiate reflux. Four to six smaller meals per day will help to prevent gastric overdistention. One of the primary factors in GERD is an incompetent lower esophageal sphincter. Adequate time needs to pass after snacking and before bedtime to decrease the risk for the reflux of gastric contents.
The nurse is participating in a free community health screening with a group of student nurses. Which statement by a student nurse requires further teaching by the licensed nurse?
- A. Colorectal cancer screening should begin at age 50.
- B. Men should have a prostate-specific antigen test starting at age 55.
- C. High-density lipoprotein should be greater than 50 mg/dL for women.
- D. Risk factors for hypertension include being over age 60 and leading a sedentary lifestyle.
Correct Answer: B
Rationale: Prostate-specific antigen testing typically starts at age 50, not 55, for average-risk men. Other statements are accurate.
A nurse is caring for a client with dumping syndrome. Which statement by the client indicates a need for further teaching?
- A. I should lie down after I eat my meals.
- B. I may experience weakness and dizziness.
- C. I should eat a low-fat, high-protein, low-carbohydrate diet.
- D. I should eat small meals and avoid drinking fluids with my meals.
Correct Answer: C
Rationale: Dumping syndrome requires a high-fat, low-carbohydrate diet to slow gastric emptying. Other statements are correct.
A postpartum client recovering from disseminated intravascular coagulopathy is to be discharged on low dosages of an anticoagulant medication. What action should the nurse encourage the client to avoid?
- A. Brushing her teeth
- B. Taking acetylsalicylic acid (aspirin)
- C. Walking long distances and climbing stairs
- D. All activities because bruising injuries can occur
Correct Answer: B
Rationale: Aspirin is an antiplatelet medication and can interact with the anticoagulant medication and increase the clotting time beyond therapeutic ranges, so avoiding aspirin is a priority. The client does not need to avoid brushing her teeth, but she should be instructed to use a soft toothbrush. Walking and climbing stairs are acceptable activities. Not all activities need to be avoided.
Dipyridamole has been prescribed for the client who underwent a valve replacement, and the nurse has provided teaching to the client about the medication. Which statement indicates that the client understands the medication instructions?
- A. This medication will prevent a stroke.
- B. This medication will prevent a heart attack.
- C. This medicine will protect my artificial heart valve.
- D. This medication will help me keep my blood pressure down.
Correct Answer: C
Rationale: Dipyridamole is an antiplatelet medication. It may be administered in combination with warfarin sodium to protect the client's artificial heart valves. Dipyridamole does not prevent stroke or heart attacks. It is an antiplatelet medication rather than an antihypertensive.