Nokea
The nurse provides dietary instructions to a client who needs to limit intake of sodium. The nurse instructs the client that which food items must be avoided because of their high sodium content? Select all that apply.
- A. Ham
- B. Apples
- C. Broccoli
- D. Soy sauce
- E. Asparagus
- F. Cantaloupe
Correct Answer: A,D
Rationale: Foods highest in sodium include table salt, some cheeses, soy sauce, cured pork, canned foods because of the preservatives, and foods such as cold cuts. Fruits and vegetables contain minimal amounts of sodium.
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The nurse in the prenatal clinic is monitoring a client who is pregnant with twins. The nurse monitors the client closely for which priority complication that is associated with a twin pregnancy?
- A. Hemorrhoids
- B. Postterm labor
- C. Maternal anemia
- D. Costovertebral angle tenderness
Correct Answer: C
Rationale: Maternal anemia often occurs in twin pregnancies because of a greater demand for iron by the fetuses. Options 1 and 4 occur in a twin pregnancy but would not be as high a priority as anemia. Option 2 is incorrect because twin pregnancies often end in prematurity.
The nurse is caring for a client who had an orthopedic injury of the leg that required surgery and the application of a cast. Postoperatively, which nursing assessment is of highest priority to assure client safety?
- A. Monitoring for heel breakdown
- B. Monitoring for bladder distention
- C. Monitoring for extremity shortening
- D. Monitoring for blanching ability of toe nail beds
Correct Answer: D
Rationale: With cast application, concern for compartment syndrome development is of the highest priority. If postsurgical edema compromises circulation, the client will demonstrate numbness, tingling, loss of blanching of toenail beds, and pain that will not be relieved by opioids. Although heel breakdown, bladder distention, or extremity lengthening or shortening can occur, these complications are not potentially life-threatening complications.
Which medication instructions should the nurse provide to a client who has been prescribed levothyroxine? Select all that apply.
- A. Monitor your own pulse rate.
- B. Take the medication in the morning.
- C. Take the medication at the same time each day.
- D. Notify the primary health care provider if chest pain occurs.
- E. Expect the pulse rate to be greater than 100 beats per minute.
- F. It may take 1 to 3 weeks for a full therapeutic effect to occur.
Correct Answer: A,B,C,D,F
Rationale: Levothyroxine is a thyroid hormone. The client is instructed to monitor her or his own pulse rate. The client is also instructed to take the medication in the morning before breakfast to prevent insomnia and to take the medication at the same time each day to maintain hormone levels. The client is told not to discontinue the medication and that thyroid replacement is lifelong. Additional instructions include contacting the primary health care provider if the rate is greater than 100 beats per minute and notifying the primary health care provider if chest pain occurs, or if weight loss, nervousness and tremors, or insomnia develops. The client is also told that full therapeutic effect may take 1 to 3 weeks and that he or she needs to have follow-up thyroid blood studies to monitor therapy.
A client has not ingested any food or liquids for 4 hours after two episodes of nausea and vomiting. What will the nurse offer the client initially now that she or he is no longer nauseated?
- A. Toast
- B. Gelatin
- C. Dry cereal
- D. Ginger ale
Correct Answer: D
Rationale: Clear liquids are best tolerated first after episodes of nausea and vomiting. If the client tolerates sips (20 to 30 mL at a time) of clear liquids, such as water or ginger ale (with the carbonation removed if better tolerated), then the amounts may be increased and gelatin, tea, and broth may be added. Once these are tolerated, solid foods such as toast, cereal, chicken, and other easily digested foods may be tried.
The nurse caring for a child admitted to the hospital with a diagnosis of viral pneumonia describes the treatment plan to the parents. The nurse determines the need for further teaching when the parents make which statement regarding the treatment?
- A. We need to be very careful since oxygen is extremely flammable.
- B. It's important that the child isn't allergic to the antibiotic that is prescribed.
- C. It's difficult to watch the needle be inserted when intravenous fluids are needed.
- D. Chest physiotherapy will loosen the congestion, so coughing will clear the lungs.
Correct Answer: B
Rationale: The therapeutic management for viral pneumonia is supportive. Antibiotics are not given unless the pneumonia is bacterial. More severely ill children may be hospitalized and given oxygen, chest physiotherapy, and intravenous fluids.