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The nurse is teaching a client with a new diagnosis of hypertension about lifestyle modifications. Which of the following statements by the client indicates a need for further teaching?
- A. I should exercise for 30 minutes most days.
- B. I should reduce my salt intake.
- C. I should avoid smoking.
- D. I should limit my coffee to one cup a day.
Correct Answer: D
Rationale: Limiting coffee to one cup a day is unnecessary, as moderate caffeine does not significantly affect blood pressure in most hypertensive patients. Options A, B, and C are correct: exercise, low-sodium diet, and smoking cessation reduce blood pressure.
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The nurse is caring for a client in the coronary care unit. The display on the cardiac monitor indicates ventricular fibrillation. What should the nurse do first?
- A. Perform defibrillation
- B. Administer epinephrine as ordered
- C. Assess for presence of pulse
- D. Institute CPR
Correct Answer: C
Rationale: Assess for presence of pulse. Verifying the absence of a pulse confirms ventricular fibrillation before proceeding with treatment.
The nurse is caring for a client with asthma who has developed gastroesophageal reflux disease (GERD). Which of the following medications prescribed for the client may aggravate GERD?
- A. Anticholinergics
- B. Corticosteroids
- C. Histamine blocker
- D. Antibiotics
Correct Answer: A
Rationale: An anticholinergic medication will decrease gastric emptying and the pressure on the lower esophageal sphincter.
Lithium carbonate is prescribed for an adult. The nurse knows the client is most likely to have which condition?
- A. Depression
- B. Mania
- C. Schizophrenia
- D. Paranoia
Correct Answer: B
Rationale: Lithium carbonate is primarily used to stabilize mood in bipolar disorder, particularly for mania.
A nurse is conducting a community wide seminar on childhood safety issues. Which of these children is at the highest risk for poisoning?
- A. 9 month-old who stays with a sitter 5 days a week
- B. 20 month-old who has just learned to climb stairs
- C. 10 year-old who occasionally stays at home unattended
- D. 15 year-old who likes to repair bicycles
Correct Answer: B
Rationale: 20 month-old who has just learned to climb stairs. Increased mobility and curiosity put toddlers at high risk for poisoning.
The nurse is teaching a client with a new diagnosis of type 1 diabetes about insulin aspart (NovoLog). Which of the following instructions should the nurse include?
- A. Take the insulin 30 minutes before meals.
- B. Mix the insulin with other insulins in the same syringe.
- C. Report any sweating or shakiness.
- D. Store the insulin at room temperature.
Correct Answer: C
Rationale: Sweating or shakiness indicate hypoglycemia, requiring reporting with insulin aspart. Options A, B, and D are incorrect.