Nokea
The nurse is reinforcing discharge instructions with a client following a partial gastrectomy. Which of the following instructions should the nurse include to prevent dumping syndrome? Select all that apply.
- A. Add high-protein foods to diet
- B. Consume high-carbohydrate meals
- C. Eat small, frequent meals
- D. Increase intake of fluids with meals
- E. Lie down after eating
Correct Answer: A,C
Rationale: High-protein foods and small, frequent meals slow gastric emptying, preventing dumping syndrome. High-carb meals and fluids with meals speed emptying, and lying down delays digestion, worsening symptoms.
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The health care provider prescribes a multivitamin regimen that includes thiamine for a client with a history of chronic alcohol abuse. The nurse is aware that thiamine is given to this client population for which purpose?
- A. To lower the blood alcohol level
- B. To prevent gross tremors
- C. To prevent Wernicke encephalopathy
- D. To treat seizures related to acute alcohol withdrawal
Correct Answer: C
Rationale: Thiamine prevents Wernicke encephalopathy, a neurological disorder from thiamine deficiency common in chronic alcoholism. It does not lower alcohol levels, prevent tremors, or treat seizures directly.
The nurse has reinforced teaching with the parent of a 4-month-old with gastroesophageal reflux. Which of the following statements by the parent would indicate a correct understanding of the teaching? Select all that apply.
- A. I will feed my baby smaller amounts more frequently
- B. I will place my baby in a side-lying position at night for sleep
- C. I will dilute my baby’s formula with water to decrease regurgitation
- D. I should massage my baby’s belly as soon as each feeding is complete
- E. I should hold my baby in an upright position for 20 to 30 minutes after each feeding
Correct Answer: A,E
Rationale: Smaller, frequent feedings and upright positioning reduce reflux. Side-lying is unsafe for sleep, diluting formula risks malnutrition, and massaging the belly post-feeding may increase regurgitation.
A client on the oncology unit is to receive heparin sodium 5 units per kilogram of body weight by subcutaneous route every 4 hours. The client weighs 105.6 lbs. How many units should the client receive in a 24-hour period?
- A. 800
- B. 1080
- C. 1440
- D. 1960
Correct Answer: C
Rationale: The client weighs 48 kg and should receive 5 units/kg, or 240 units every 4 hours. This would be 1440 units in 24 hours. The answers in A, B, and D are incorrect calculations.
There have been several clients recently who have fallen in the long-term care facility. The nurse would like to reduce the number of falls. Which action is likely to do the most to help prevent falls?
- A. Ask the nursing assistants to watch the clients more closely.
- B. Restrain clients who cannot walk independently.
- C. Provide call bells so the clients can carry with them when they walk.
- D. Keep beds in the lowest position unless the nurse is performing care for the client.
Correct Answer: D
Rationale: Low bed height minimizes fall injury risk, a key prevention strategy. Closer watching, restraints, or call bells are less effective or restrictive.
A couple asks the nurse about risks of several birth control methods. What is the most appropriate response by the nurse?
- A. Norplant is safe and may be removed easily
- B. Oral contraceptives should not be used by smokers
- C. Depo-Provera is convenient with few side effects
- D. The IUD gives protection from pregnancy and infection
Correct Answer: B
Rationale: Oral contraceptives should not be used by smokers. The use of oral contraceptives in a woman who smokes increases her risk of cardiovascular problems, such as thromboembolic disorders.