Nokea
The nurse provides dietary instruction to the parents of a child with a diagnosis of cystic fibrosis. The nurse should tell the parents that which diet plan should be followed?
- A. Fat free
- B. Low in protein
- C. Low in sodium
- D. High in calories
Correct Answer: D
Rationale: Children with cystic fibrosis are managed with a high-calorie, highprotein diet; pancreatic enzyme replacement therapy; fat-soluble vitamin supplements; and if nutritional problems are severe, nighttime gastrostomy feedings or parental nutrition. Fats are not restricted unless steatorrhea cannot be controlled by increased pancreatic enzymes. Sodium intake is unrelated to this disorder.
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Allopurinol has been prescribed for a client to treat gouty arthritis. The nurse teaches the client to anticipate which prescription if an acute attack occurs?
- A. Doubling the dose of the allopurinol
- B. Stopping the allopurinol and taking acetylsalicylic acid (aspirin)
- C. Stopping the allopurinol and taking a nonsteroidal anti-inflammatory drug
- D. Adding colchicine or a nonsteroidal anti-inflammatory drug to the treatment plan
Correct Answer: D
Rationale: Allopurinol helps prevent an attack of gouty arthritis, but it does not relieve the pain. Therefore, another medication such as colchicine or a nonsteroidal anti-inflammatory drug must be added if an acute attack occurs. Because acute attacks may occur more frequently early during the course of therapy with allopurinol, some health care providers recommend taking the two products concurrently during the first 3 to 6 months.
The nurse assesses cranial nerve XII in the client who sustained a stroke. Which action should the nurse ask the client to perform?
- A. Extend the arms.
- B. Extend the tongue.
- C. Turn the head toward the nurse's arm.
- D. Focus the eyes on an object held by the nurse.
Correct Answer: B
Rationale: Cranial nerve XII (hypoglossal) controls tongue movement, so extending the tongue tests its function. Other actions test different nerves or motor functions, not relevant to cranial nerve XII.
The labor and delivery nurse expects which clients to be at high risk for amniotic fluid embolus (AFE)? Select all that apply.
- A. a 27-year-old client with preeclampsia
- B. a healthy 23-year-old anticipating a vaginal delivery
- C. a 42-year-old expecting her second child via cesarean section
- D. a 32-year-old client with diabetes anticipating induced labor
Correct Answer: A,C,D
Rationale: Preeclampsia, cesarean section, and induced labor increase AFE risk due to uterine trauma or hyperstimulation. A healthy vaginal delivery has lower risk.
A client is being discharged to home after prostatectomy for treatment of benign prostatic hyperplasia. Which point should the nurse plan to teach the client as part of the discharge teaching?
- A. Mowing the lawn is allowed after 1 week.
- B. Avoid lifting more than 50 pounds for 4 to 6 weeks after surgery.
- C. Drink at least 15 glasses of water a day to minimize clot formation.
- D. Notify the primary health care provider if fever, increased pain, or an inability to void occurs.
Correct Answer: D
Rationale: Notifying the primary health care provider about fever, increased pain, or inability to void is critical to detect complications like infection or urinary obstruction. Mowing the lawn is too strenuous too soon, lifting more than 20 pounds is prohibited, and 15 glasses of water daily is excessive; 6 to 8 glasses are sufficient.
The nurse teaches a client with hypertension to recognize the signs/symptoms that may occur during periods of elevated blood pressure. The nurse determines that the client needs additional teaching if the client states that which sign/symptom is associated with this condition?
- A. Epistaxis
- B. Dizziness
- C. Blurred vision
- D. A feeling of fullness in the head
Correct Answer: D
Rationale: A feeling of fullness in the head is more likely associated with a sinus condition than hypertension. Cerebrovascular symptoms of hypertension include early morning headaches, occipital headaches, epistaxis, dizziness, blurred vision, lightheadedness, and vertigo. The client should be aware of these signs/symptoms and report them if they occur. The client should also be taught to self-monitor the blood pressure.