Nokea
The nurse is reinforcing teaching for a client who is a college athlete and was recently diagnosed with moderate persistent asthma. The nurse should instruct the client to avoid
- A. penicillin antibiotics
- B. talc-containing products
- C. strenuous physical activity
- D. secondhand smoke exposure
Correct Answer: D
Rationale: Secondhand smoke is a known asthma trigger, exacerbating symptoms. Penicillin, talc, and strenuous activity are not primary asthma triggers, though activity may require premedication with bronchodilators.
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The nurse is caring for a client who performs frequent urinary self-catheterizations. Which of the following client assessments would indicate a potential for a latex allergy? Select all that apply.
- A. History of angioedema with lisinopril
- B. History of epilepsy
- C. Known allergy to avocados and bananas
- D. Known allergy to shellfish
- E. Lip swelling when blowing up balloons
Correct Answer: C,E
Rationale: Allergies to avocados, bananas, and latex (balloons) indicate a potential latex allergy due to cross-reactivity. Angioedema with lisinopril, epilepsy, and shellfish allergies are unrelated to latex sensitivity.
The nurse is reviewing recommended dietary modifications with the parents of a 6-month-old client with phenylketonuria. Which of the following information should the nurse include? Select all that apply.
- A. A low-phenylalanine diet is required
- B. Meat and dairy products should not be introduced into the diet
- C. Phenylketonuria is self-limiting and dietary modifications are temporary
- D. Specially prepared infant formula is necessary
- E. Tyrosine should be removed from the diet
Correct Answer: A,B,D
Rationale: Phenylketonuria requires a lifelong low-phenylalanine diet, avoiding meat and dairy, and using special formula to prevent neurological damage. It is not self-limiting, and tyrosine is needed, not removed.
The nurse has reinforced teaching with a client who has gout. Which of the following statements by the client would indicate a correct understanding of the teaching? Select all that apply.
- A. Drink plenty of fluids, including at least 2 L of water daily
- B. Reduce your consumption of alcohol or abstain from drinking
- C. Take aspirin instead of acetaminophen for minor pain or discomfort
- D. Implement a diet and physical activity regimen to maintain a healthy weight
- E. Select protein sources that are low in purine, such as low-fat dairy products
Correct Answer: A,B,D,E
Rationale: Fluids, reduced alcohol, weight management, and low-purine proteins reduce uric acid and gout flares. Aspirin can increase uric acid levels, worsening gout, and should be avoided.
The nurse is preparing to instill dialysate for a client who is receiving peritoneal dialysis. It would be a priority for the nurse to
- A. place the client in the semi-Fowler position
- B. record the characteristics of the dialysate output
- C. use sterile technique when spiking and attaching the bag of dialysate
- D. ensure that the drainage collection bag is below the level of the abdomen
Correct Answer: C
Rationale: Sterile technique when spiking and attaching the dialysate bag prevents peritonitis, a life-threatening complication. Semi-Fowler positioning, recording output, and bag placement are important but secondary to infection prevention.
The nurse is reviewing the plan of care for multiple clients receiving opioids for pain management. Which client has the greatest risk for respiratory depression?
- A. 20-year-old client with chronic bronchitis who is receiving inhaled albuterol therapy every 4 hours
- B. 30-year-old client with opioid use disorder who had rotator cuff repair surgery this morning
- C. 50-year-old client with sleep apnea and left foot cellulitis who is scheduled for a bone scan later today
- D. 70-year-old client with chronic obstructive pulmonary disease who had knee replacement this morning
Correct Answer: D
Rationale: The 70-year-old with COPD is at highest risk for opioid-induced respiratory depression due to age-related reduced lung capacity and COPD-related impaired gas exchange. Chronic bronchitis and opioid use disorder increase risk but are less severe in this context.