Nokea
The nurse is providing teaching to a client experiencing chronic constipation. Which of the following meals would be the best choice for this client in order to promote a bowel movement?
- A. steak and a baked potato
- B. brussels sprouts and a whole grain roll
- C. white rice with chicken
- D. ham sandwich with tomato soup
Correct Answer: B
Rationale: Brussels sprouts and whole grain rolls are high in fiber, promoting bowel movements.
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The nurse in the emergency department (ED) is caring for a 10-year-old client.
Item 2 of 5
Nurses' Notes
1322: 10-year-old client and his parents report an 8-day history of a brownish-raised lesion over the back of his left leg. The parents report that the size of the rash has increased. The parents report returning from a one-week camping trip three weeks ago. The parents deny efficacy with over-the-counter antihistamine creams. The client's parents deny that the child has had a fever but has felt 'warm' occasionally and endorsed an intermittent headache. They report an area of firmness in the child's groin. On assessment, there was an erythematous, raised, nonpainful, oval patch on the back of his left leg. This was an enlargement of an inguinal lymph node. The child is alert and fully oriented and denies any pain. Peripheral pulses palpable 2+. No cyanosis or edema in the extremities. Lung sounds clear bilaterally. The parents report that the child did not receive the seasonal influenza vaccine. He currently takes a multivitamin for iron deficiency anemia and was hospitalized one year ago for an appendectomy. The parents state that the child’s sibling had influenza one month ago. Vital signs: T 98.8°F (37.1°C); HR 78 beats/min; RR 16 breaths/min; BP 110/76 mm Hg. SpO2 97% on room air.
The nurse considers if the client may have an infection caused by a tick. Click to specify if the features are consistent with the disease process of Rocky Mountain spotted fever (RMSF) or Lyme Disease.
- A. Fever
- B. Petechial rash that becomes diffuse
- C. Erythema migrans (bullseye rash)
- D. Myalgia
- E. Causative agent Rickettsia rickettsii
- F. Causative agent Borrelia burgdorferi
Correct Answer: C (Lyme Disease), F (Lyme Disease)
Rationale: The bullseye rash and Borrelia burgdorferi are specific to Lyme disease. Fever and myalgia can occur in both RMSF and Lyme disease, but the petechial rash and Rickettsia rickettsii are specific to RMSF.
The nurse is discussing infection control with a group of nursing students. Which conditions require contact precautions?
- A. Rubeola
- B. Psoriasis
- C. Pediculosis
- D. Rubella
- E. Scabies
- F. Clostridium difficile
Correct Answer: C, E, F
Rationale: Pediculosis, scabies, and Clostridium difficile require contact precautions due to direct contact transmission.
The nurse is discharging an adolescent with sickle cell disease. Which statement should the nurse include in the teaching?
- A. Keep a water bottle with you at school so that you can stay hydrated
- B. Follow a high-calorie, high-protein diet
- C. Do not take the annual influenza vaccine
- D. Drink extra fluids if you have to travel on an airplane
- E. Daily aerobic exercise is recommended
Correct Answer: A, B, D
Rationale: Hydration, high-calorie/protein diet, and extra fluids during travel help prevent sickle cell crises. The influenza vaccine is recommended, and excessive aerobic exercise may trigger crises.
The nurse is performing a physical assessment on a newborn. The nurse assessed 3+ brachial pulses, cold and pale feet, decreased capillary refill time in the feet, and warm and pink hands. Which cardiac disease process do these assessment findings support?
- A. Tetralogy of Fallot (TOF)
- B. Hypoplastic left heart syndrome
- C. Coarctation of the aorta (COA)
- D. Transposition of the great arteries
Correct Answer: C
Rationale: These findings suggest coarctation of the aorta, with reduced lower extremity perfusion due to aortic narrowing.
The nurse is caring for a client who is edentulous. Which of the following diet orders should the nurse request from the healthcare provider?
- A. a low sodium diet
- B. a mechanical soft diet
- C. a renal diet
- D. a high-fiber diet
Correct Answer: B
Rationale: A mechanical soft diet is appropriate for an edentulous client to ensure safe chewing and swallowing.