Nokea
The nurse is reinforcing teaching about ulcer prevention with a client newly diagnosed with peptic ulcer disease. Which of the following client statements indicate appropriate understanding of teaching? Select all that apply.
- A. I need to avoid taking medicines like ibuprofen without a prescription.
- B. I should avoid drinking excess coffee or cola.
- C. I should enroll in a smoking cessation program.
- D. I should reduce or eliminate my intake of alcoholic beverages.
- E. I will eliminate whole wheat foods, like breads and cereals, from my diet.
Correct Answer: A,B,C,D
Rationale: Avoiding NSAIDs (ibuprofen), excess coffee/cola, smoking, and alcohol reduces ulcer irritation and promotes healing. Whole wheat foods are beneficial for digestion and not contraindicated.
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The home care nurse is observing the client's spouse performing a colostomy irrigation. Which action needs correction?
- A. The spouse holds the irrigating solution about 18 inches above the stoma.
- B. The client is sitting on the toilet seat for the irrigation.
- C. The spouse is using 1000 mL of irrigating solution.
- D. The spouse uses petroleum jelly to lubricate the tip of the catheter.
Correct Answer: D
Rationale: Petroleum jelly is not suitable for lubricating colostomy irrigation catheters, as it may degrade materials or harbor bacteria; water-soluble lubricant is preferred. The height, volume, and position are appropriate.
The licensed practical nurse is monitoring a client receiving an IV of Nipride in D5W. The IV bag has a foil covering, and the nurse notes that the IV fluid has a light brownish tint. The nurse should:
- A. Discard the solution.
- B. Obtain a bag of normal saline.
- C. Cover both the solution bag and the IV tubing with foil.
- D. Do nothing because the solution is expected to be light brown in color.
Correct Answer: D
Rationale: Nipride (nitroprusside) is light-sensitive and turns light brown, which is normal if protected by foil. No action is needed.
A home care client is scheduled for dialysis. He asks the nurse if he should take his antihypertensive medication before going for dialysis. How should the nurse respond?
- A. He should take all regularly scheduled medications.
- B. Antihypertensives should not be taken before dialysis because the blood pressure drops during dialysis.
- C. He should check with the physician because it varies from person to person.
- D. He should take it with him and take it if his blood pressure rises during the treatment.
Correct Answer: B
Rationale: Antihypertensives are often held before dialysis to prevent hypotension, as dialysis can lower blood pressure. Routine administration, physician checks, or conditional dosing are less appropriate.
An adult client who is ambulating in the corridor with the nurse becomes dizzy and faint. What should the nurse do at this time?
- A. Have her put her head between her legs
- B. Quickly go to get help
- C. Guide her to a chair in the corridor and ease her into it
- D. Encourage the client to walk faster
Correct Answer: C
Rationale: Guiding the client to a chair prevents falls and ensures safety during dizziness. Head positioning, seeking help, or faster walking are unsafe or impractical.
The nurse is explaining the effects of cocaine abuse to a pregnant client. Which of the following must the nurse understand as a basis for teaching?
- A. Cocaine use can cause fetal growth retardation
- B. The drug has been linked to neural tube defects
- C. Newborn withdrawal generally occurs immediately after birth
- D. Breast feeding promotes positive parenting behaviors
Correct Answer: A
Rationale: Cocaine is vasoconstrictive, and this effect in the placental vessels causes fetal growth retardation.