The nurse is teaching about irritable bowel syndrome (IBS). Which of the following would be most important?
- A. Reinforcing the need for a balanced diet
- B. Encouraging the client to drink 16 ounces of fluid with each meal
- C. Telling the client to eat a diet low in fiber
- D. Instructing the client to limit his intake of fruits and vegetables
Correct Answer: A
Rationale: A balanced diet with adequate fiber (soluble for IBS) helps regulate bowel function and reduce IBS symptoms. High fluid intake with meals may exacerbate symptoms, low-fiber diets can worsen constipation, and limiting fruits/vegetables is not advised.
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The mother of a one-year-old wants to know when she should begin toilet-training her child. The nurse's response is based on the knowledge that sufficient sphincter control for toilet training is present by:
- A. 12-15 months of age
- B. 18-24 months of age
- C. 26-30 months of age
- D. 32-36 months of age
Correct Answer: B
Rationale: Sufficient sphincter control for toilet training typically develops between 18-24 months, when children gain the physical and cognitive ability to control urination and defecation.
A client is receiving peritoneal dialysis. He has been taught to warm the dialyzing fluid prior to instilling it because:
- A. Warmed solution helps keep the body temperature maintained within a normal range during instillation
- B. Warmed solution helps dilate the peritoneal blood vessels
- C. Warmed solution decreases the risk of peritoneal infection
- D. Warmed solution promotes a relaxed abdominal muscle
Correct Answer: B
Rationale: Instilling a cool solution does not significantly lower the body temperature during peritoneal dialysis. Warmed solution does help dilate the peritoneal blood vessels, facilitating the exchange of fluids. Warming the dialysate does not decrease the risk of peritoneal infection. Sterile technique decreases this risk. Relaxing the abdominal muscles does not facilitate peritoneal dialysis.
The nurse is caring for a client with a history of schizophrenia. Which medication is most likely to be prescribed?
- A. Fluoxetine (Prozac)
- B. Risperidone (Risperdal)
- C. Clonazepam (Klonopin)
- D. Bupropion (Wellbutrin)
Correct Answer: B
Rationale: Risperidone, an antipsychotic, is used to treat schizophrenia by managing hallucinations and delusions. Fluoxetine and bupropion are antidepressants, and clonazepam is for anxiety.
The nurse is caring for a client with a history of schizophrenia. The nurse should expect the client to have:
- A. Hallucinations
- B. Memory loss
- C. Tremors
- D. Joint pain
Correct Answer: A
Rationale: Schizophrenia is characterized by hallucinations, delusions, and disorganized thinking, with hallucinations being a common symptom.
The nurse is caring for a client with a history of a pneumothorax who is being prepared for discharge. The nurse should teach the client to:
- A. Avoid air travel
- B. Sleep on the affected side
- C. Resume heavy lifting
- D. Restrict fluid intake
Correct Answer: A
Rationale: Air travel can cause pressure changes that risk pneumothorax recurrence. Sleeping position, lifting, and fluids are secondary, with lifting typically restricted.
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