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The nurse is reinforcing information on dietary management to a group of clients with newly diagnosed type 2 diabetes. Which meal represents the best adherence to the principles of and recommendations for diabetic meal planning?
- A. Baked tilapia with tomato salsa, steamed white rice
- B. Black bean chili with brown rice, mixed greens salad
- C. Grilled chicken breast with baked French fries
- D. Hamburger on a whole wheat bun with lettuce and tomato
Correct Answer: B
Rationale: Baked bean chili with brown rice and salad provides fiber, lean protein, and vegetables, balancing blood sugar. Fries and hamburger buns are higher in simple carbs, less ideal for diabetes control.
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Which nursing action is essential in the care of an adult following a left side cardiac catheterization?
- A. Keep the client NPO for two hours.
- B. Ask the client about a shellfish allergy.
- C. Check pulses proximal to the insertion site.
- D. Check the insertion site for bleeding.
Correct Answer: D
Rationale: Checking the insertion site for bleeding is critical post-catheterization to detect hematoma or hemorrhage, ensuring patient safety.
The nurse is interviewing a 5-year-old client who is reporting abdominal pain. Which of the following are effective strategies for communicating with the child? Select all that apply.
- A. Allow the child to describe the symptoms
- B. Ask closed-ended questions to obtain pertinent information
- C. Explain procedures to match the child's concrete thinking
- D. Interview the child separately from the parents
- E. Maintain an eye-level position when speaking with the child
Correct Answer: A,C,E
Rationale: Allowing the child to describe symptoms encourages open communication, and interviewing separately reduces parental influence, ensuring accurate reporting. Closed-ended questions may limit a young child’s ability to express complex symptoms.
The nurse is caring for an elderly client after hip replacement surgery. The client is distressed because he has not had a bowel movement in 3 days. Which action by the nurse would be most appropriate?
- A. Administer the prescribed as-needed milk of magnesia
- B. Ask dietary services to add more fruits and vegetables to the client’s tray
- C. Notify the registered nurse
- D. Perform a focused abdominal assessment
Correct Answer: D
Rationale: A focused abdominal assessment determines the cause of constipation (e.g., impaction, obstruction) before interventions like laxatives, dietary changes, or RN notification, ensuring safe and targeted care.
The nurse is teaching the parent of a 7-year-old client with celiac disease. Which statement by the parent would require follow-up?
- A. My child can consume small amounts of barley
- B. My child is allowed to eat rice, corn, and potatoes
- C. My child needs to be on a gluten-free diet for life
- D. My child should avoid eating processed foods
Correct Answer: A
Rationale: Barley contains gluten, which is harmful in celiac disease, indicating a need for further teaching. Rice, corn, potatoes, lifelong gluten-free diet, and avoiding processed foods are correct.
The nurse is reviewing the medication profile for a client with chronic obstructive pulmonary disease. Which prescription should the nurse question?
- A. Amlodipine
- B. Codeine
- C. Ipratropium
- D. Methylprednisolone
Correct Answer: B
Rationale: Codeine, an opioid, suppresses cough and respiration, risking respiratory depression in COPD. Amlodipine treats hypertension, ipratropium relieves bronchospasm, and methylprednisolone reduces inflammation, all appropriate for COPD.