Nokea
The nurse is reinforcing teaching to a client being discharged on enoxaparin therapy following total knee replacement surgery. Which statement made by the nurse is most appropriate?
- A. Eliminate green, leafy, vitamin K-rich vegetables from your diet
- B. Mild bruising or redness may occur at the injection site
- C. You can take over-the-counter drugs such as ibuprofen to relieve mild discomfort
- D. You will need PT/INR assessments at regular intervals while on enoxaparin therapy
Correct Answer: B
Rationale: Mild bruising or redness at the injection site is a common side effect of enoxaparin, a low-molecular-weight heparin. Vitamin K restriction applies to warfarin, ibuprofen increases bleeding risk, and PT/INR monitoring is not required for enoxaparin.
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The nurse is reinforcing teaching to a client with a history of diverticulitis about lifestyle changes the client should make to reduce the risk of future episodes. Which information should the nurse reinforce to reduce the risk of future episodes? Select all that apply.
- A. Drink plenty of fluids
- B. Exercise regularly
- C. Follow a low-fiber diet
- D. Increase whole grains, fruits, and vegetables in the diet
- E. Increase intake of red meat
Correct Answer: A,B,D
Rationale: Fluids, exercise, and high-fiber foods (whole grains, fruits, vegetables) prevent constipation and reduce diverticulitis risk. Low-fiber diets and red meat increase risk by promoting constipation and inflammation.
The nurse is talking with a client recently diagnosed with HIV infection about home and lifestyle alterations. Which of the following statements indicate that the client correctly understands the teaching? Select all that apply.
- A. I should avoid eating raw or undercooked meats and eggs to prevent infections
- B. I need to make sure my family members understand not to borrow my shaving razors
- C. I do not need to use barrier methods of protection if my sexual partner is also HIV positive
- D. I have started to use latex-free condoms during sexual intercourse because I have a latex allergy
Correct Answer: A,B,D
Rationale: Avoiding raw foods, not sharing razors, and using latex-free condoms reduce infection and transmission risks. Barrier methods are still needed with HIV-positive partners to prevent superinfection.
The nurse is caring for a client with Meniere's disease. When teaching the client about the disease, the nurse should explain that the client should avoid foods high in
- A. Calcium
- B. Fiber
- C. Sodium
- D. Carbohydrate
Correct Answer: C
Rationale: Sodium. The client with Meniere's disease has an alteration in the balance of the fluid in the inner ear (endolymph). A low sodium diet will aid in reducing the fluid. Sodium restriction is also ordered as adjunct to diuretic therapy.
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 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.