Nokea
The nurse recognizes that teaching a 44-year-old woman following a laparoscopic cholecystectomy has been effective when the patient states which of the following?
- A. I can expect yellow-green drainage from the incision for a few days.
- B. I can remove the bandages on my incisions tomorrow and take a shower.
- C. I should plan to limit my activities and not return to work for 4 to 6 weeks.
- D. I will always need to maintain a low-fat diet since I no longer have a gallbladder.
Correct Answer: B
Rationale: The correct answer is, 'I can remove the bandages on my incisions tomorrow and take a shower.' After a laparoscopic cholecystectomy, patients have Band-Aids over the incisions and can typically remove the bandages the next day. Patients are usually discharged the same or next day and have minimal restrictions on their daily activities. Yellow-green drainage from the incision would be abnormal, requiring the patient to contact their healthcare provider. While a low-fat diet may be recommended initially after surgery, it is not a lifelong requirement, as the body can adjust to the absence of the gallbladder over time. Choice A is incorrect as abnormal drainage should be reported. Choice C is incorrect as most patients can resume normal activities within a few days to a week. Choice D is incorrect as maintaining a low-fat diet is not a lifelong necessity after a cholecystectomy.
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A client is being instructed in the use of an incentive spirometer. Which of the following statements from the nurse indicates correct teaching about using this device?
- A. Lie back in a reclining position while using the spirometer.
- B. Take slow deep breaths to reach your goal.
- C. Set a goal of using the spirometer at least 3 times per day.
- D. Practice coughing after taking 10 breaths.
Correct Answer: D
Rationale: An incentive spirometer is a device used to improve lung function and reduce the risk of atelectasis. The correct way to use the spirometer is by sitting up and taking slow, deep breaths to achieve the set goal, not by lying back in a reclining position or taking rapid, quick breaths. Setting a goal of using the spirometer multiple times a day is beneficial, but it is not the best indicator of correct teaching. After using the spirometer, the client should practice coughing to help clear any loosened secretions that may have occurred during the breathing exercises.
A 38-year-old patient with cirrhosis has ascites and 4+ edema of the feet and legs. Which nursing action will be included in the plan of care?
- A. Restrict daily dietary protein intake.
- B. Reposition the patient every 4 hours.
- C. Place the patient on a pressure-relieving mattress.
- D. Perform passive range of motion daily.
Correct Answer: C
Rationale: Placing the patient on a pressure-relieving mattress is crucial to decrease the risk of skin breakdown, especially with significant edema and ascites. Adequate dietary protein intake is essential in patients with ascites to improve oncotic pressure and prevent malnutrition. Repositioning the patient every 4 hours alone may not be sufficient to prevent skin breakdown, especially in areas prone to pressure ulcers. Performing passive range of motion exercises is important for maintaining joint mobility but does not directly address the risk of skin breakdown associated with prolonged pressure on vulnerable areas.
A patient with severe Gastroesophageal Reflux Disease is receiving discharge teaching. Which of these statements by the patient indicates a need for more teaching?
- A. ''I'm going to limit my meals to 2-3 per day to reduce acid secretion.''
- B. ''I'm going to make sure to remain upright after meals and elevate my head when I sleep.''
- C. ''I won't be drinking tea or coffee or eating chocolate anymore.''
- D. ''I'm going to start trying to lose some weight.''
Correct Answer: A
Rationale: The correct answer is ''I'm going to limit my meals to 2-3 per day to reduce acid secretion.'' This statement indicates a need for more teaching because large meals increase the volume and pressure in the stomach, delaying gastric emptying, and worsening symptoms of Gastroesophageal Reflux Disease (GERD). The recommended approach is to eat smaller, more frequent meals (4-6 small meals a day) to reduce acid reflux. Choices B, C, and D demonstrate good understanding of GERD management by highlighting the importance of staying upright after meals, avoiding trigger foods like tea, coffee, and chocolate, and addressing weight management, which are all appropriate strategies to manage GERD symptoms.
The nurse is working in a support group for clients with HIV. Which point is most important for the nurse to stress?
- A. They must inform household members of their condition.
- B. They must take their medications exactly as prescribed.
- C. They must abstain from substance use.
- D. They must avoid large crowds.
Correct Answer: B
Rationale: The correct answer is that clients with HIV must take their medications exactly as prescribed. Antiretrovirals need to be taken as directed to prevent the development of drug-resistant strains and maintain treatment effectiveness. Missing doses can compromise the effectiveness of future treatments. Choice A, informing household members, is important for social support but not the most critical aspect of managing the condition. Choice C, abstaining from substance use, is important but not as crucial as medication adherence. Choice D, avoiding large crowds, is not directly related to HIV management as long as the individual's immune system is not significantly compromised.
Why is it important to genotype HCV before initiating drug therapy?
- A. Side effects of nucleotide analogs
- B. Measures for improving the appetite
- C. Ways to increase activity and exercise
- D. Administering alpha-interferon (Intron A)
Correct Answer: B
Rationale: Genotyping of HCV plays a crucial role in managing treatment as it helps determine the most effective therapy for the specific viral strain. It allows healthcare providers to personalize treatment regimens and predict response rates. The statement about acute HCV infection converting to chronic state is accurate, highlighting the need for appropriate management. Immune globulin and vaccines are not available for HCV, and Ribavirin is commonly used for chronic HCV infection. Improving appetite is essential in liver health as adequate nutritional intake supports hepatocyte regeneration. Choices A, C, and D are incorrect as they do not address the specific importance of genotyping in HCV treatment or the significance of appetite improvement in liver function.