Nokea
The nurse is teaching a smoking cessation program. He will state that which of the following benefits of quitting appear within one year?
- A. risk of coronary heart disease is the same as that of a nonsmoker
- B. carbon monoxide level in blood drops to normal
- C. risk of dying from lung cancer is about half that of a smoker's
- D. risk of having a stroke is reduced to that of a nonsmoker's
Correct Answer: B
Rationale: Within 24 hours of quitting smoking, carbon monoxide levels drop to normal. Other benefits (A, C, D) take longer (5-15 years for heart disease, 10 years for lung cancer, 5-10 years for stroke risk). Thus, B is the correct benefit within one year.
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Which nursing intervention is most appropriate to maintain the patency of a client's nasogastric tube?
- A. Maintain a constant connection to low-intermittent suction
- B. Irrigate the tube as per physician's order
- C. Suction the mouth and nose every shift
- D. Perform a daily fecal occult blood sample
Correct Answer: B
Rationale: The correct answer is to irrigate the tube as per physician's order. A client with a nasogastric tube is at risk of the tube kinking or clotting off, which can lead to complications such as abdominal distention or vomiting. To ensure the patency of the tube, the nurse should follow the physician's orders and facility policy to irrigate the tube with water or a solution as needed. Maintaining a constant connection to low-intermittent suction (Choice A) is not typically done to maintain tube patency. Suctioning the mouth and nose every shift (Choice C) is not directly related to maintaining nasogastric tube patency. Performing a daily fecal occult blood sample (Choice D) is unrelated to maintaining the patency of a nasogastric tube.
The nurse has implemented a plan of care for a client diagnosed with a cervical 5 (C5) spinal cord injury to promote health maintenance. Which client outcome indicates the effectiveness of the plan?
- A. Maintenance of intact skin
- B. Regaining of bladder and bowel control
- C. Performance of activities of daily living independently
- D. Independent transfer of self to and from the wheelchair
Correct Answer: A
Rationale: A C5 spinal cord injury results in quadriplegia with no sensation below the clavicle, including most of the arms and hands. The client maintains the partial movement of the shoulders and elbows. Maintaining intact skin is an outcome for spinal cord injury clients. The remaining options are inappropriate for this client.
Mrs. G is seen for follow-up after testing for chronically high blood glucose levels. Her physician diagnoses her with type 1 diabetes. Which of the following information is part of this client's education about this condition?
- A. Type 1 diabetes occurs due to increased carbohydrate intake and lack of exercise
- B. Type 1 diabetes is managed through diet and exercise
- C. Type 1 diabetes is caused by destruction of beta cells in the pancreas
- D. Type 1 diabetes leads to the body's cells rejecting insulin
Correct Answer: C
Rationale: Type 1 diabetes is an autoimmune condition where the immune system attacks and destroys the beta cells in the pancreas, leading to a lack of insulin production. Insulin is essential for regulating blood glucose levels and enabling cells to use glucose for energy. Understanding that type 1 diabetes results from the destruction of beta cells helps patients comprehend the need for insulin replacement therapy. Choices A and B are incorrect as type 1 diabetes is not primarily caused by diet or exercise habits. Choice D is incorrect because type 1 diabetes is not about the body's cells rejecting insulin but rather the lack of insulin production due to beta cell destruction.
The nurse is assigned to care for a client being admitted with a diagnosis of cirrhosis and ascites. Which dietary measure should the nurse expect to be prescribed for the client?
- A. Sodium restriction
- B. Increased fat intake
- C. Decreased carbohydrates
- D. Calorie restriction of 1500 daily
Correct Answer: A
Rationale: If the client has ascites, sodium and possibly fluids would be restricted in the diet. The client should maintain a normal amount of fat intake. The diet should supply sufficient carbohydrates to maintain weight and spare protein. The total daily calories should range between 2000 and 3000 . The diet should provide ample protein to rebuild tissue but not an amount that will precipitate hepatic encephalopathy.
The nurse instructs a client with mild preeclampsia about home care measures. Which statement by the client indicates to the nurse that the teaching has been effective concerning the assessment of complications for preeclampsia?
- A. I need to check my weight every day at different times during the day.
- B. I need to take my blood pressure each morning and alternate arms each time.
- C. I need to check my urine with a dipstick every day for protein and call the doctor if it is 2+ or more.
- D. As long as the home care nurse is visiting me daily, I do not have to keep my next primary health care provider's appointment.
Correct Answer: C
Rationale: Classic signs of preeclampsia include hypertension and proteinuria. The client diagnosed with preeclampsia needs to be instructed to report any increases in blood pressure; 2+ proteinuria; weight gain of more than 1 pound per week; the presence of edema in the face, hands, and sacral area; and decreased fetal activity to the primary health care provider immediately to prevent worsening of the preeclamptic condition. The weight needs to be checked at the same time each day, after voiding, before breakfast, and with the client wearing the same clothes in order to obtain reliable weight readings. Blood pressure measurements need to be taken in the same arm every day in a sitting position to obtain consistent and accurate readings. It is important to keep primary health care provider appointments even if the client is receiving visits from a home care nurse.