Nokea
The nurse is teaching a client with hypertension about dietary modifications. Which food choice indicates a need for further teaching?
- A. Fresh apple
- B. Baked chicken
- C. Canned soup
- D. Steamed broccoli
Correct Answer: C
Rationale: Canned soup is high in sodium, which exacerbates hypertension, indicating a need for further teaching. Apple (A), chicken (B), and broccoli (D) are low-sodium and appropriate.
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A client is taking Rifadin (rifampin) 600 mg PO daily for pulmonary tuberculosis. The nurse should tell the client to:
- A. Take the medication with juice
- B. Expect red discoloration of the urine
- C. Take the medication before going to bed at night
- D. Take the medication only if night sweats occur
Correct Answer: B
Rationale: Rifampin causes harmless red-orange discoloration of urine, sweat, and tears, which clients should be informed about to avoid alarm. It can be taken with or without food, timing is not restricted to bedtime, and it is taken daily, not conditionally.
Which diet selection by a client with a decubitus ulcer would indicate a clear understanding of the proper diet for healing of the ulcer?
- A. Tossed salad, milk, and a slice of caramel cake
- B. Vegetable soup and crackers, and a glass of iced tea
- C. Baked chicken breast, broccoli, wheat roll, and an orange
- D. Hamburger, French fries, and corn on the cob
Correct Answer: C
Rationale: Healing decubitus ulcers requires a diet high in protein, vitamins (especially C and A), and zinc. Baked chicken breast (protein), broccoli (vitamin C), wheat roll (carbohydrates), and an orange (vitamin C) provide these nutrients. Options A, B, and D lack sufficient protein or include less nutrient-dense foods (e.g., caramel cake, French fries).
A female client comes for her second prenatal visit. The nurse-midwife tells her, 'Your blood tests reveal that you do not show immunity to the German measles.' Which notation will the nurse include in her plan of care for the client? 'Will need . . .
- A. Rh-immune globulin at the next visit'
- B. Rh-immune globulin within 3 days of delivery'
- C. Rubella vaccine at the next visit'
- D. Rubella vaccine after delivery on the day of discharge'
Correct Answer: D
Rationale: Rh immune globulin is given to Rh-negative mothers to prevent the maternal Rh immune response. Rh immune globulin is given to Rh-negative mothers to prevent the maternal Rh immune response. The rubella vaccine is not given during pregnancy because of its teratogenicity. Nonimmune mothers are vaccinated early in the postpartum period to prevent future infection with the rubella virus.
The client is admitted at 32 weeks gestation with a diagnosis of gestational hypertension. Which assessment finding is most significant?
- A. Proteinuria of 2+
- B. Blood pressure of 140/90
- C. Edema of the hands and face
- D. Weight gain of 2 pounds per week
Correct Answer: A
Rationale: Proteinuria of 2+ is a significant finding in gestational hypertension as it suggests progression to preeclampsia which can lead to severe complications. BP of 140/90 edema and weight gain are concerning but less specific without proteinuria.
A client with Pneumocystis jiroveci pneumonia is receiving intravenous Pentam (pentamidine). While administering the medication, the nurse should give priority to checking the client's:
- A. Deep tendon reflexes
- B. Blood pressure
- C. Urine output
- D. Tissue turgor
Correct Answer: B
Rationale: Pentamidine can cause hypotension, especially during IV administration, requiring close blood pressure monitoring. Reflexes, urine output, and turgor are less immediate concerns.