Nokea
The nurse should instruct the client to eat which of the following foods to obtain the best supply of vitamin B12?
- A. Whole grains.
- B. Green leafy vegetables.
- C. Meats and dairy products.
- D. Broccoli and brussels sprouts.
Correct Answer: C
Rationale: Vitamin B12 is primarily found in animal products, such as meats and dairy products, making them the best dietary sources. Whole grains, green leafy vegetables, broccoli, and brussels sprouts contain little to no vitamin B12. Clients with B12 deficiency, such as those with pernicious anemia, should be encouraged to consume meats and dairy to meet their B12 needs.
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Which of the following factors places a client at greatest risk for skin cancer?
- A. Fair skin and history of chronic sun exposure.
- B. Caucasian race and history of hypertension.
- C. Dark skin and family history of skin cancer.
- D. Dark skin and history of hypertension.
Correct Answer: A
Rationale: Fair skin and chronic sun exposure increase skin cancer risk due to higher UV sensitivity and cumulative damage. Dark skin offers some protection.
The nurse is preparing a client for a paracentesis. The nurse should:
- A. Have the client void immediately before the procedure.
- B. Place the client in a side-lying position.
- C. Initiate an I.V. line to administer sedatives.
- D. Place the client on nothing-by-mouth (NPO) status 6 hours before the procedure.
Correct Answer: A
Rationale: Voiding before paracentesis (A) prevents bladder injury during the procedure. Side-lying (B) is incorrect; upright is preferred. IV sedatives (C) are not routine, and NPO status (D) is unnecessary.
The client's family asks why the client who had a splenectomy has a nasogastric (NG) tube. An NG tube is used to:
- A. Move the stomach away from where the spleen was removed.
- B. Irrigate the operative site.
- C. Decrease abdominal distention.
- D. Assess for the gastric pH as peristalsis returns.
Correct Answer: C
Rationale: An NG tube is used post-splenectomy to decompress the stomach and decrease abdominal distention, which can reduce pressure on the surgical site and promote healing. It does not move the stomach, irrigate the site, or assess gastric pH.
The nurse will anticipate which of the following problems that can result for the older adult undergoing abdominal surgery?
- A. Uncrossed scarring.
- B. Decreased melanin and melanocytes.
- C. Decreased healing.
- D. Increased immunocompetence.
Correct Answer: C
Rationale: Older adults have slower wound healing due to reduced collagen synthesis and cellular turnover, increasing the risk of delayed recovery post-surgery.
When giving discharge instructions to the client with vasospastic disorder (Raynaud's phenomenon), the nurse should explain that the expected outcome is a total of the symptoms by:
- A. Decreasing the influence of the sympathetic nervous system on the tissues in the hands and feet
- B. Decreasing the pain by producing analgesia
- C. Increasing the blood supply to the affected area
- D. Increasing monoamine oxidase
Correct Answer: C
Rationale: The expected outcome in Raynaud's is increased blood supply to the affected areas by reducing vasospasm, alleviating symptoms like numbness and pallor. Sympathetic nervous system influence, analgesia, and monoamine oxidase are not directly targeted.