Nokea
The nurse is reinforcing education about lifestyle modifications for a client newly diagnosed with Meniere disease. Which statement by the client indicates a need for further teaching?
- A. I need to enroll in a smoking cessation program.
- B. I need to restrict the amount of potassium in my diet.
- C. I will lie down and avoid walking unassisted during acute attacks.
- D. I will limit the amount of caffeine and alcohol that I consume.
Correct Answer: B
Rationale: Restricting potassium isn't indicated for Ménière's disease; a low-sodium diet is typically recommended to reduce fluid retention. Smoking cessation, lying down during attacks, and limiting caffeine/alcohol are appropriate.
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A 57 year-old male client has a hemoglobin of 10 mg/dl and a hematocrit of 32%. What would be the most appropriate follow-up by the home care nurse?
- A. Ask the client if he has noticed any bleeding or dark stools
- B. Tell the client to call 911 and go to the emergency department immediately
- C. Schedule a repeat Hemoglobin and Hematocrit in 1 month
- D. Tell the client to schedule an appointment with a hematologist
Correct Answer: A
Rationale: Ask the client if he has noticed any bleeding or dark stools. These values indicate mild anemia, and the first step is to assess for potential sources of blood loss.
Which of these findings indicate that a pump set to deliver a basal rate of 10 ml per hour plus PRN morphine drip for breakthrough pain is not working?
- A. The client complains of discomfort at the IV insertion site
- B. The client states 'I just can't get relief from my pain'
- C. The level of the drug is 100 ml at 8 AM and is 80 ml at noon
- D. The infusion is running at a rate higher than expected
Correct Answer: C
Rationale: The minimal dose is 10 ml per hour, which would mean 40 mls are given in a 4 hour period. Only 60 mls should be left at noon. The pump is not functioning when more than expected medicine is left in the container.
An older adult is diagnosed with open-angle glaucoma. Which comment by the client indicates understanding of the management of the condition?
- A. I will take the eye drops every day.'
- B. I hope the medicine works and I am cured soon.'
- C. My wife is worried that I may give her glaucoma.'
- D. How long will it be before I need surgery?'
Correct Answer: A
Rationale: Daily eye drops control intraocular pressure in open-angle glaucoma, a chronic condition, indicating understanding, unlike expecting a cure, contagiousness, or immediate surgery.
A client calls the nurse with a complaint of sudden deep throbbing leg pain. What is the appropriate first action by the nurse?
- A. Suggest isometric exercises
- B. Maintain the client on bed rest
- C. Ambulate for several minutes
- D. Apply ice to the extremity
Correct Answer: B
Rationale: Maintain the client on bed rest. The finding suggests deep vein thrombosis. The client must be maintained on bed rest and the provider notified immediately.
Which of the following instructions should be given to a client regarding testicular self-exam?
- A. The testicular exam should be done bimonthly.
- B. The testicular exam should be done while in the shower or tub.
- C. A small pen light should be used to transilluminate the scrotal sac.
- D. The testicular exam should be done yearly.
Correct Answer: B
Rationale: Testicular self-examination (TSE) is recommended monthly, not bimonthly or yearly, and is best performed during or after a warm shower or bath when the scrotum is relaxed, making it easier to detect abnormalities. Transillumination is a medical procedure, not part of TSE.