Nokea
The nurse is reinforcing teaching for a client with atrial fibrillation who has a new prescription for warfarin. The nurse should instruct the client to avoid excess or inconsistent intake of which of the following foods? Select all that apply.
- A. red meat
- B. bananas
- C. broccoli
- D. spinach
- E. kale
Correct Answer: C,D,E
Rationale: Broccoli, spinach, and kale are high in vitamin K, which can antagonize warfarin's anticoagulant effect. Consistent intake is key, but excess can reduce effectiveness. Red meat and bananas have minimal vitamin K and don't significantly affect warfarin.
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A client returns from surgery after having a suprapubic prostatectomy. Upon assessing the client, the nurse notes that his urine is bright red with many clots. Which of the following nursing actions is most appropriate?
- A. Check the client's vital signs and notify the physician.
- B. Check whether the continuous irrigation is working properly.
- C. Recognize that this is a normal finding after surgery and continue post-op care.
- D. Apply traction on the catheter and notify the physician.
Correct Answer: B
Rationale: Bright red urine with clots suggests a need to check the continuous bladder irrigation system to ensure it is functioning to prevent clot obstruction.
The nurse has reinforced teaching with the parent of a pediatric client with newly diagnosed hemophilia A. Which of the following statements by the parent would indicate a correct understanding of the teaching? Select all that apply.
- A. I should avoid using icepacks if my child is injured.
- B. I should provide a high-fat, high-protein diet for my child.
- C. My child should wear emergency medical identification at all times.
- D. My child can participate in noncontact sports such as swimming.
- E. I should avoid giving my child medication containing aspirin.
Correct Answer: C,D,E
Rationale: Medical identification ensures prompt treatment in emergencies. Noncontact sports like swimming are safe. Aspirin increases bleeding risk and should be avoided. Ice packs are beneficial for injuries to reduce swelling, and diet doesn't require high-fat/protein for hemophilia management.
A client on the psychiatric unit does not get to the dining room to eat because she is continually washing her hands and doesn't finish until after lunch. What should be included in the nursing care plan?
- A. Give the client a choice between eating lunch and performing her ritual.
- B. Tell the client an hour before lunch so she can perform her ritual before lunch.
- C. Discuss the problem with the client and ask her why she washes her hands so long.
- D. Tell the client she cannot wash her hands at all if she is going to be late for lunch.
Correct Answer: B
Rationale: Advance notice allows the client with OCD to complete rituals before lunch, facilitating nutrition without confrontation. Choices, discussions, or bans are less effective.
The nurse is experiencing repeated unwanted sexual advances from a health care provider (HCP). Which of the following actions should the nurse take? Select all that apply.
- A. Seek emotional support from a trusted source.
- B. Consult the facility's sexual harassment policy.
- C. Report the behavior to the supervisor immediately.
- D. Document each occurrence according to facility policy.
- E. Confront the HCP outside the workplace about the behavior.
Correct Answer: A,B,C,D
Rationale: Seeking support aids coping, reviewing policy clarifies procedures, reporting to a supervisor initiates formal action, and documentation provides evidence. Confronting outside work risks escalation and is unsafe.
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.