Nokea
The nurse monitors a client who has followed a vegan diet for several years. Which client statement would indicate a possible complication resulting from a vegan diet?
- A. I have had some visual disturbances while driving at night.
- B. I have had trouble falling asleep over the past few months.
- C. Scaly patches of skin are developing on my elbows and knees.
- D. Sometimes my hands and feet get a tingling sensation.
Correct Answer: A
Rationale: Night vision disturbances suggest vitamin A deficiency, common in vegan diets lacking sufficient beta-carotene sources. Insomnia, scaly skin, and tingling are less specific to vegan diet complications, potentially relating to other causes like stress or neuropathy.
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The nurse is contributing to a staff education program about non-pharmacological pain management techniques for newborns and infants. Which of the following techniques should the nurse include in the program? Select all that apply.
- A. Allow a newborn to suck on a gloved finger dipped in sucrose solution during a circumcision
- B. Apply a cold pack to a newborn’s heel 30 minutes before performing a heel stick
- C. Assist the parent to hold a newborn skin-to-skin during an IM injection
- D. Offer a pacifier to an infant while performing venipuncture
- E. Swaddle an infant while leaving the affected arm unwrapped during an IV dressing change
Correct Answer: A,C,D,E
Rationale: Sucrose sucking, skin-to-skin contact, pacifier use, and swaddling reduce pain perception in infants. Cold packs are not recommended for newborns due to risk of tissue damage and ineffective pain relief in this context.
In taking the history of a pregnant woman, which of the following would the nurse recognize as the primary contraindication for breast feeding?
- A. Age 40 years
- B. Lactose intolerance
- C. Family history of breast cancer
- D. Use of cocaine on weekends
Correct Answer: D
Rationale: Use of cocaine on weekends. Cocaine use is harmful to the breastfed infant, even with intermittent use.
An adult is receiving daily doses of hydrocortisone. Which comment by the client indicates a need for further instruction?
- A. I will take the medicine in the morning.'
- B. I will not stop the drug unless the doctor tells me to.'
- C. I take the pills with milk or food.'
- D. I eat lots of salt and avoid bananas and oranges.'
Correct Answer: D
Rationale: Hydrocortisone does not require high salt or potassium restriction; this suggests misunderstanding, possibly confusing with other conditions. Morning dosing, not stopping abruptly, and taking with food are correct.
A client recently lost a child due to poisoning. The client tells the nurse, 'I don't want to make any new friends right now.' This is an example of which of the following indicators of stress?
- A. emotional behavioral indicator
- B. spiritual indicator
- C. sociocultural indicator
- D. intellectual indicator
Correct Answer: C
Rationale: Avoiding new social connections reflects a sociocultural stress response, altering relationships due to grief. The other indicators involve different stress manifestations. Psychosocial Integrity
Which of these clients is at greatest risk for the complications associated with osteoporosis?
- A. A 22-year-old woman with anorexia nervosa who is not having menstrual periods
- B. A 65-year-old Asian-American man who is sedentary, has a low calcium intake, and takes corticosteroids for chronic obstructive pulmonary disease
- C. A 70-year-old postmenopausal woman who has limited mobility due to rheumatoid arthritis, for which she takes corticosteroids, and who drinks a bottle of wine by herself each evening
- D. A 70-year-old woman who takes estrogen therapy, was very athletic in her youth playing tennis and golf, and takes anticonvulsant therapy as a result of a head injury suffered in an auto accident three years ago
Correct Answer: C
Rationale: The 70-year-old postmenopausal woman has multiple risk factors: age, immobility, corticosteroid use, and alcohol consumption, maximizing osteoporosis complication risk.