Nokea
The nurse is working with a client who has just been diagnosed with pancreatic cancer. The client says, 'I have so much left to do. I'm too young to die like this.' Which of the following stages of Kübler-Ross's five stages of grieving does the nurse recognize in this client?
- A. anger
- B. denial
- C. bargaining
- D. acceptance
- E. depression
Correct Answer: C
Rationale: The client's statement reflects bargaining, expressing a desire to delay death to accomplish more.
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The nurse has been preparing a client diagnosed with chronic obstructive pulmonary disease for discharge. Which statement by the client indicates the need for further teaching about nutrition?
- A. I will rest a few minutes before I eat.
- B. I will not eat as much cabbage as I once did.
- C. I will certainly try to drink 3 L of fluid every day.
- D. It's best to eat three large meals a day, so that I will get all my nutrients.
Correct Answer: D
Rationale: Large meals distend the abdomen and elevate the diaphragm, which may interfere with breathing for the client diagnosed with chronic obstructive pulmonary disease. Resting before eating may decrease the fatigue that is often associated with chronic obstructive pulmonary disease. Gas-forming foods may cause bloating, which interferes with normal diaphragmatic breathing. Adequate fluid intake helps liquefy pulmonary secretions.
After a cleft lip repair, the nurse instructs the parents about cleaning of the lip repair site. The nurse should plan to use which solution when demonstrating this procedure to the parents?
- A. Tap water
- B. Sterile water
- C. Full-strength hydrogen peroxide
- D. Half-strength hydrogen peroxide
Correct Answer: B
Rationale: After cleft lip repair, the site is cleansed with sterile water using a cotton swab after feeding and as prescribed. Agency procedure should also be followed. The parents should be instructed to use a rolling motion starting at the suture line and rolling out. Tap water is not a sterile solution. Hydrogen peroxide may disrupt the integrity of the site.
A client has urinary calculi that are composed of uric acid, and the nurse teaches the client dietary measures to prevent the further development of the calculi. The nurse determines that the client understands the dietary measures if the client states that it is necessary to avoid consuming what food products?
- A. Milk
- B. Yogurt
- C. Spinach, chocolate, and tea
- D. Sardines, herring, and organ meats
Correct Answer: D
Rationale: The client diagnosed with a uric acid stone should limit the intake of foods that are high in purines. Organ meats, sardines, herring, and other high-purine foods are eliminated from the diet. Foods with moderate levels of purines, such as red and white meats and some seafood, are also limited. Milk, yogurt, spinach, chocolate, and tea are recommended dietary changes to prevent calculi that are composed of calcium phosphate or calcium oxalate.
Which instruction should the nurse include in the teaching plan for a client taking iron supplements to correct iron deficiency anemia?
- A. Eat a low-fiber diet.
- B. Limit the intake of fluids.
- C. Limit the intake of meat, fish, and poultry.
- D. Avoid taking the iron supplements with milk or antacids.
Correct Answer: D
Rationale: The client should avoid taking the iron supplements with milk or antacids because these items decrease the absorption of iron. The client should also avoid taking the iron with food, if possible. Finally, the client should take in sufficient fiber and fluids to prevent constipation as a side effect of iron therapy. The client should increase the intake of natural sources of iron, such as meats, fish, and poultry.
The nurse is caring for a client who is 38 weeks pregnant and plans to breastfeed. This is the client's first child, and she expresses concern about lactation. The nurse tells the client that which measures stimulate lactation? Select all that apply.
- A. breast massage
- B. frequent breastfeeding
- C. pumping breasts between feedings
- D. vigorous exercise one week after birth
- E. applying cold compresses to the breasts
Correct Answer: A,B,C
Rationale: Breast massage, frequent breastfeeding, and pumping stimulate milk production. Exercise and cold compresses do not.