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The occupational health nurse has had five (5) clients come to the clinic complaining of abdominal cramping, nausea, and vomiting. Which information should the nurse teach the employees to decrease the spread of this condition?
- A. Teach the employees to cough into the sleeve.
- B. Teach the housekeepers to use an antibacterial soap.
- C. Teach the coworkers to get a hepatitis vaccine.
- D. Teach the employees to wash their hands frequently.
Correct Answer: D
Rationale: Frequent handwashing prevents the spread of gastroenteritis, likely causing these symptoms. Coughing into sleeves, antibacterial soap, and hepatitis vaccines are less relevant.
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A client has had a liver biopsy. After the procedure, the nurse should position him on his right side with a pillow under his rib cage. What is the primary reason for this position?
- A. To immobilize the diaphragm
- B. To facilitate full chest expansion
- C. To minimize the danger of aspiration
- D. To reduce the likelihood of bleeding
Correct Answer: D
Rationale: Right-side positioning with a pillow applies pressure to the biopsy site, reducing the risk of bleeding.
The female client diagnosed with anorexia nervosa is admitted to the hospital. The client is 67 inches tall and weighs 40 kg. Which client problem has the highest priority?
- A. Altered nutrition.
- B. Low self-esteem.
- C. Disturbed body image.
- D. Altered sexuality.
Correct Answer: A
Rationale: Altered nutrition is the priority due to severe underweight (BMI ~13.2), risking organ failure and death. Self-esteem, body image, and sexuality are psychosocial and secondary.
Which statement by the client diagnosed with hepatitis warrants immediate intervention by the clinic nurse?
- A. I will not drink any type of beer or mixed drink.
- B. I will get adequate rest so I don’t get exhausted.
- C. I had a big hearty breakfast this morning.
- D. I took some cough syrup for this nasty head cold.
Correct Answer: D
Rationale: Cough syrup may contain hepatotoxic ingredients (e.g., acetaminophen), posing a risk to a hepatitis patient’s liver, requiring immediate intervention. Other statements are appropriate or benign.
The nurse is planning the care of a client diagnosed with lower esophageal sphincter dysfunction. Which dietary modifications should be included in the plan of care?
- A. Allow any of the client's favorite foods as long as the amount is limited.
- B. Have the client perform eructation exercises several times a day.
- C. Eat four (4) to six (6) small meals a day and limit fluids during mealtimes.
- D. Encourage the client to consume a glass of red wine with one (1) meal a day.
Correct Answer: C
Rationale: Eating small, frequent meals reduces stomach distension, which can trigger reflux, and limiting fluids during meals prevents excessive gastric volume. Favorite foods may include triggers, eructation exercises are not standard, and alcohol like red wine can worsen GERD.
The client recovering from acute pancreatitis who has been NPO asks the nurse, “When can I start eating again?” Which response by the nurse is most accurate?
- A. “As soon as you start to feel hungry you can begin eating.”
- B. “When I hear that your bowel sounds are active and you are passing flatus.”
- C. “When your pain is controlled and your serum lipase level has decreased.”
- D. “You will be NPO for at least more 2 weeks; oral intake stimulates the pancreas.”
Correct Answer: C
Rationale: A. Regaining appetite is a positive sign, but it must be accompanied by a decrease in pain before the client is allowed to take food orally. B. Intestinal peristalsis may be slowed due to inflammation associated with acute pancreatitis, but the return of bowel sounds and flatus is not used to determine when to begin oral intake. C. This response is correct. Once pain is controlled and the serum enzyme levels begin to decrease, the client can begin oral intake. These are signs that the pancreas is healing. D. There is no specific time limit for being NPO.