Nokea
The nurse is reinforcing home care instructions to a client newly diagnosed with osteomalacia. Which of the following client statements indicate proper understanding of teaching? Select all that apply.
- A. I will avoid foods high in calcium and phosphorus.'
- B. I will avoid going outside on sunny days.'
- C. I will eat foods that are fortified with vitamin D.'
- D. I will engage in physical activity to increase bone strength.'
- E. I will use a cane to help me get around better.'
Correct Answer: C, D
Rationale: Vitamin D-rich foods (C) and physical activity (D) improve bone health in osteomalacia. Avoiding calcium/phosphorus (A), sunlight (B), or using a cane (E) are incorrect or unnecessary.
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The nurse is assisting the physician with an examination of a client with Addison's disease. During the examination, the nurse will note which change in the client's integumentary system?
- A. Edema of the hands and feet
- B. Hirsutism
- C. Bronze pigmentation
- D. Pendulous abdomen
Correct Answer: C
Rationale: Addison's disease causes bronze pigmentation due to increased ACTH. Edema , hirsutism , and pendulous abdomen are not typical.
Laboratory reference ranges
INR (Therapeutic – atrial fibrillation)
2.0-3.0
The nurse has reinforced teaching for a client with atrial fibrillation who is receiving warfarin. Which of the following statements by the client would indicate a correct understanding of the teaching? Select all that apply.
- A. Antibiotics can affect my INR value.'
- B. I am going to eat more leafy green vegetables.'
- C. I will take the medication at the same time every day.'
- D. I understand that my INR value should be between 4 and 5.'
- E. If I miss a dose of medication, I'll double my dose the next day.'
Correct Answer: A, C
Rationale: Antibiotics affecting INR (A) and consistent timing (C) are correct. More leafy greens (B) can lower INR, INR of 4-5 (D) is too high, and doubling doses (E) is dangerous.
Which test for diabetes measures the long-term management of the disease?
- A. Fasting blood sugar
- B. Glucose tolerance test
- C. Finger stick glucose test
- D. Glycosylated hemoglobin
Correct Answer: D
Rationale: Glycosylated hemoglobin (HbA1c) measures average blood glucose over 2-3 months, assessing long-term diabetes control, unlike fasting, tolerance, or finger stick tests, which are short-term.
The nurse is preparing to obtain a urine specimen for culture and sensitivity from a client who has an indwelling urinary catheter that was inserted 2 days ago. Which of the following actions should the nurse take?
- A. Attach a sterile syringe to the specimen port.
- B. Withdraw a sample of fluid from the balloon port.
- C. Empty urine from the urinary drainage bag into a specimen container.
- D. Collect all urine from the urinary drainage bag during a 24-hour period.
Correct Answer: A
Rationale: Using a sterile syringe at the specimen port (A) ensures a clean sample. Balloon port (B), drainage bag (C), or 24-hour collection (D) risk contamination.
The nurse reinforces teaching about methotrexate to a client with rheumatoid arthritis. It is most important to address which topic regarding this drug?
- A. Need for an eye examination
- B. Need for sunblock
- C. Risk for infection
- D. Risk for kidney injury
Correct Answer: C
Rationale: Methotrexate suppresses the immune system, significantly increasing the risk for infection (C). This is a critical teaching point to ensure the client takes precautions. Eye exams (A), sunblock (B), and kidney injury (D) are less directly associated with methotrexate's primary risks.