Nokea
The nurse is reinforcing teaching on nutritional therapy for a client with chronic kidney disease. Which statement indicates that further teaching is needed?
- A. Because I have chronic kidney disease, I should avoid canned soups and cold-cut sandwiches.
- B. I can use a salt substitute because I am required to restrict both sodium and potassium in my daily diet.
- C. I must avoid eating raw carrots and tomatoes on my salads because I take hemodialysis treatments.
- D. The popsicles I eat should be counted in my daily fluid intake because they become liquid at room temperature.
Correct Answer: B
Rationale: Salt substitutes often contain potassium, which is restricted in chronic kidney disease due to impaired kidney excretion. This statement indicates a misunderstanding. The other statements correctly reflect sodium restriction, phosphorus restriction, and fluid intake considerations.
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A client recovering from a head injury is receiving medication and nutritional feedings by nasogastric tube. The doctor has ordered medication to prevent seizure activity. The medication is supplied by the pharmacy in tablet form. Before administering the medication, the nurse should:
- A. Crush the medication and envelop it in a small amount of ice cream before giving.
- B. Help the client to sit upright while giving the tablet by mouth.
- C. Crush the tablet, mix in 100 ccs of tube feeding, and administer via NG tube.
- D. Ask the pharmacist if the medication is available in liquid form.
Correct Answer: D
Rationale: For NG tube administration, liquid medication is preferred to ensure proper delivery and absorption. Crushing tablets may alter efficacy, and oral administration is inappropriate.
Health promotion activities are designed to help clients:
- A. reduce the risk of illness.
- B. maintain maximal function.
- C. promote healthy habits related to health care.
- D. all of the above.
Correct Answer: D
Rationale: Health promotion encompasses reducing illness risk, maintaining function, and fostering healthy habits, addressing all aspects of well-being. Health Promotion and Maintenance
A client has had a tracheostomy for 2 weeks after a motor vehicle accident. Which task could the RN safely delegate to unlicensed assistive personnel (UAP)?
- A. Teach the client how to cough up secretions
- B. Changes the tracheostomy trach ties
- C. Monitor for skin breakdown around the stoma
- D. Suction the tracheostomy when needed
Correct Answer: B
Rationale: Unlicensed assistive personnel should be able to perform routine tracheostomy care, such as changing trach ties, which is a standard, low-risk task.
The nurse coming on duty notifies the unit of a delay due to a motor vehicle accident. The off-going nurse has an important appointment and must leave on time. How should the off-going nurse handle the situation?
- A. Ask another nurse to watch the current assigned clients until the incoming nurse arrives
- B. Tape-record a report and leave a cell phone number to call if there are any questions
- C. Tell the charge nurse of the impending need to leave and that client coverage is required
- D. Write out a report about the clients for the incoming nurse prior to leaving
Correct Answer: C
Rationale: Notifying the charge nurse ensures proper client coverage and maintains continuity of care without abandoning patients. Asking another nurse assumes their availability, tape-recording lacks interaction, and a written report alone does not ensure immediate supervision.
The nurse in the outpatient mental health clinic is evaluating the effectiveness of the treatment regimen for a client with dependent personality disorder. Which of the following statements by the client would indicate that the treatment regimen has been effective?
- A. I took the bus here today because my parents could not drive me.
- B. I appreciate all the time you have spent trying to help me feel better.
- C. I know I am not good at my job because I made a mistake at work today.
- D. I plan to stay with my cousin while my parents go away on vacation next week.
Correct Answer: A
Rationale: Clients with dependent personality disorder have a persistent and extreme need to be taken care of that manifests as submissive and clinging behaviors and fear of separation. Additional characteristics of dependent personality disorder may include:• Difficulty in making day-to-day decisions • An excessive need for advice, reassurance, and nurturing from others • Lack of self-confidence or fear of doing things independently • Fear of confrontation or expressing disagreement with others • Feelings of helplessness and anxiety when alone or fear of being unable to take care of oneself The ability to make decisions about and carry out daily activities without assistance (eg, planning alternate transportation) indicate that the treatment plan has been effective