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The nurse reviews discharge instructions with a client who has gastroesophageal reflux disease (GERD). Which instruction is most important for the nurse to emphasize?
- A. Minimize intake of spicy foods.
- B. Remain upright following meals.
- C. Avoid wearing tight fitting clothes.
- D. Begin a smoking cessation program.
Correct Answer: B
Rationale: Remaining upright after meals prevents acid reflux by facilitating digestion, making it the most critical instruction for GERD management.
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A client is admitted with heart failure (HF) and left ventricular hypertrophy. Which intervention is most likely to avert development of cardiomegaly and improve myocardial contractility?
- A. Teach about compliance to reduce blood pressure.
- B. Provide rest periods and portable oxygen.
- C. Maintain continuous monitoring of heart rate and rhythm.
- D. Administer nitroglycerin daily.
Correct Answer: A
Rationale: Reducing blood pressure decreases cardiac workload, preventing cardiomegaly and improving contractility.
An older adult client, at risk for osteoporosis, reports taking a multivitamin daily. In developing a teaching plan for the client, which follow- up Information should the nurse obtain?
- A. What time of day the multivitamin is taken.
- B. The amount of calcium in the multivitamin.
- C. Usual activity after taking the multivitamin.
- D. If the multivitamin is taken with a meal or snack
Correct Answer: B
Rationale: Confirming calcium content in the multivitamin ensures adequate intake for bone health, critical for osteoporosis prevention.
History and Physical
Nurses' Notes
Orders
Imaging Studies
The client is a young male who appears to be 25 to 30 years old. He was found unconscious on a sidewalk by a jogger who was passing by. The jogger called an ambulance, and the emergency medical technicians (EMTS) transported the client to the hospital. The client is arousable but unable to say what his name is or what happened to him. A STAT head computed tomography (CT) scan in the emergency department showed no abnormalities, so the client will be admitted to the medical floor for observation and further tests.
Exhibits
The nurse provides education about seizures to the client and asks the client to explain what he understands about his condition.
The nurse provides education about seizures to the client and asks the client to explain what he understands about his condition. For each statement click to specify if the client demonstrates an understanding or no understanding.
- A. I can stop taking the phenytoin If I go for a while and don't have a seizure.'
- B. Having a medic alert bracelet might be a good idea, but it is up to me to decide if I want it or not.'
- C. I don't need to go to the hospital if I have another seizure unless it is a very long seizure or if I have several in a row.'
- D. There are really no lifestyle changes that I can do that will affect my risk for having another seizure.'
- E. I may never know why I started having seizures.'
Correct Answer: E
Rationale: Only the statement about unknown seizure causes shows understanding; others reflect misconceptions about medication, safety, and lifestyle.
An older adult client arrives at the outpatient eye surgery clinic for a right cataract extraction and lens implant. During the immediate postoperative period, which intervention should the nurse implement?
- A. Encourage deep breathing and coughing exercises.
- B. Teach a family member to administer eye drops.
- C. Provide an eye shield to be worn while sleeping
- D. Obtain vital signs every 2 hours during hospitalization.
Correct Answer: C
Rationale: An eye shield is crucial to protect the operated eye from accidental injury during sleep, preventing rubbing and potential complications. Deep breathing and coughing can increase intraocular pressure, teaching medication administration is not an immediate priority, and frequent vital sign monitoring is excessive for cataract surgery.
A client with chronic venous insufficiency is being discharged from the hospital, and plans to return home. Which client statement indicates an understanding of home care instructions?
- A. I will lift weights every other day.'
- B. I will be able to stand as long as my legs do not hurt.'
- C. I will avoid sitting and crossing my legs.'
- D. I will need to get someone to walk my dog.'
Correct Answer: C
Rationale: Avoiding prolonged sitting and leg crossing improves venous return, aligning with chronic venous insufficiency management.