Nokea
The nurse is teaching the client with gout about a diet low in purines. Which of the following is lowest in purine?
- A. Roast chicken
- B. Beef liver
- C. Fried shrimp
- D. Scrambled eggs
Correct Answer: D
Rationale: Scrambled eggs are low in purines, suitable for a gout diet, unlike high-purine foods like liver and shrimp.
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If the client is in shock, how should the nurse position the client while continuing to assess and provide care?
- A. Prone with the arm supported
- B. In Fowler's position with the knees flexed
- C. Supine with the legs elevated
- D. Lateral with the back extended
Correct Answer: C
Rationale: Supine with legs elevated improves venous return in shock.
The client with a lower leg amputation has edema, so the NA elevates the client's residual left limb on pillows. What is the most appropriate action by the nurse when observing that the client's leg has been elevated?
- A. Thank the nursing assistant (NA) for being so observant and intervening appropriately to treat the client's edema of the residual limb.
- B. Remove the pillows, raise the foot of the bed, and inform the NA that the limb should not be elevated on pillows because it could cause a flexion contracture.
- C. Inform the NA that this was the correct action at this time in the client's recovery, but once the client's incision heals, the leg should not be elevated.
- D. Report the incident to the surgeon and tell the NA to complete a variance report because the client's leg should not have been elevated.
Correct Answer: B
Rationale: B. The nurse should perform this action. Flexion, abduction, and external rotation of the residual lower limb are avoided to prevent hip contracture.
The nurse writes the problem of 'pain' for a client diagnosed with lumbar strain. Which nursing interventions should be included in the plan of care? Select all that apply.
- A. Assess pain on a 1-to-10 scale.
- B. Administer pain medication prn.
- C. Provide a regular bedpan for elimination.
- D. Assess surgical dressing every four (4) hours.
- E. Perform a position change by the log roll method every two (2) hours.
Correct Answer: A,B,E
Rationale: Pain assessment, PRN medication, and log rolling address pain and prevent exacerbation in lumbar strain. Bedpans are unnecessary, and surgical dressings are irrelevant without surgery.
If the client is allergic to penicillin, the nurse must question a medical order for which type of antibiotic?
- A. An aminoglycoside such as gentamicin sulfate (Garamycin)
- B. A cephalosporin such as cefaclor (Ceclor)
- C. A tetracycline such as doxycycline (Vibramycin)
- D. A sulfonamide such as trimethoprim/sulfamethoxazole (Bactrim)
Correct Answer: B
Rationale: Cephalosporins (e.g., cefaclor) have a cross-sensitivity with penicillin, risking allergic reactions in penicillin-allergic clients. The other antibiotics listed do not share this cross-reactivity.
The client is three (3) hours postoperative left AKA. The client tells the nurse, 'My left foot is killing me. Please do something.' Which intervention should the nurse implement?
- A. Explain to the client his left leg has been amputated.
- B. Medicate the client with a narcotic analgesic immediately.
- C. Instruct the client on how to perform biofeedback exercises.
- D. Place the client's residual limb in the dependent position.
Correct Answer: B
Rationale: Phantom limb pain is treated with analgesics; narcotics provide immediate relief. Explaining the amputation dismisses pain, biofeedback is long-term, and dependent positioning is inappropriate.