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The nurse is talking with a client with obesity who has a new prescription for a lipase inhibitor. Which of the following statements by the client would require follow-up?
- A. I will take this medication in the morning on an empty stomach.
- B. I should consume a diet that is low in fat while taking this medication.
- C. I may experience oily stools and flatulence while taking this medication.
- D. I will take fat-soluble vitamins at least 2 hours before or after taking this medication.
Correct Answer: A
Rationale: Lipase inhibitors like orlistat should be taken with or within an hour of meals containing fat, not on an empty stomach, to effectively block fat absorption. The other statements are correct: low-fat diet minimizes side effects, oily stools and flatulence are common, and vitamins should be timed to avoid malabsorption.
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The nurse is caring for a 70-year-old client with diabetic retinopathy. Which of the following statements by the client would be a priority to follow up?
- A. Half of my vision looks like it is being covered by a curtain
- B. I wear reading glasses when reading the newspaper
- C. My vision is cloudy with a glare around bright lights
- D. Colors appear less bright than when I was younger
Correct Answer: A
Rationale: A 'curtain' over half the vision suggests retinal detachment, a medical emergency requiring immediate intervention to prevent permanent vision loss. Reading glasses are normal, cloudy vision or glare may indicate cataracts, and less bright colors are age-related, but none are as urgent.
Which comment by the client is most significant in light of the fact that he has Ménière's disease?
- A. I take a walk every day.
- B. I listen to my iPOD a lot.
- C. I smoke a pack of cigarettes a day.
- D. It is very noisy at my workplace.
Correct Answer: C
Rationale: Cigarette smoking has been shown to aggravate Ménière's disease. The client will be told to stop smoking to decrease the frequency and severity of Ménière's. Walking, listening to an IPOD or other electronic device, and exposure to noise have not been shown to be related to Ménière's disease.
The greatest time savers when planning client care include all of the following except:
- A. reacting to the crisis of the moment.
- B. setting goals.
- C. planning.
- D. specifying priorities.
Correct Answer: A
Rationale: Reacting to crises is reactive and disrupts efficient care planning. Setting goals, planning, and prioritizing save time by organizing care proactively. Coordinated Care
A 6-month old has been hospitalized for the treatment of acute diarrhea. Discharge diet includes the use of Isomil instead of Similac formula until the next clinic appointment. Which of the following statements explains the change in infant formula?
- A. Isomil is less expensive than Similac.
- B. The infant has developed a permanent lactose intolerance.
- C. Isomil is an excellent oral rehydration formula.
- D. Infants commonly have a lactose intolerance after a diarrheal illness.
Correct Answer: D
Rationale: Isomil is a soy-based formula, used temporarily after diarrheal illness because infants may develop transient lactose intolerance due to mucosal damage. Permanent lactose intolerance is rare, and Isomil is not an oral rehydration formula.
A nurse who is a native English speaker admits an elderly Mexican-American migrant worker after an accident that occurred during work. To facilitate communication the nurse should initially
- A. Request a Spanish interpreter
- B. Speak through the family or co-workers
- C. Use pictures, letter boards, or monitoring
- D. Assess the client's ability to speak English
Correct Answer: D
Rationale: Assess the client's ability to speak English. Despite the cultural heritage, the nurse cannot make assumptions. Stereotyping is to be avoided. The nurse should assess the client's comfort and ability in speaking English.