Nokea
The parents of a child with cystic fibrosis express concern about how the disease was transmitted to their child. The nurse should explain that:
- A. A disease carrier also has the disease.
- B. Two parents who are carriers may produce a child who has the disease.
- C. A disease carrier and an affected person will never have children with the disease.
- D. A disease carrier and an affected person will have a child with the disease.
Correct Answer: B
Rationale: Cystic fibrosis is an autosomal recessive disorder, meaning two carrier parents have a $25\%$ chance of having a child with the disease, as each parent can pass on the defective gene.
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A client with a history of peptic ulcer disease is prescribed sucralfate (Carafate). The nurse should instruct the client to:
- A. Take the medication 1 hour before meals.
- B. Take the medication with meals.
- C. Take the medication at bedtime.
- D. Stop the medication if constipation occurs.
Correct Answer: A
Rationale: Sucralfate should be taken 1 hour before meals to coat the stomach lining and protect ulcers.
The nurse is teaching a client with gastroesophageal reflux disease (GERD) about lifestyle modifications. Which recommendation is appropriate?
- A. Eat large meals to reduce acid production
- B. Sleep flat to promote digestion
- C. Avoid lying down for 2 hours after eating
- D. Drink coffee to relax the esophagus
Correct Answer: C
Rationale: Avoiding lying down for 2 hours after eating prevents acid reflux by allowing gravity to keep stomach contents in place.
The nurse is monitoring a client who is receiving a blood transfusion when the client reports diaphoresis, warmth, and a backache. The nurse should take which actions? Select all that apply.
- A. Remove the IV catheter.
- B. Document the occurrence.
- C. Stop the blood transfusion.
- D. Contact the primary health care provider.
- E. Hang 0.9% sodium chloride solution.
Correct Answer: B,C,D,E
Rationale: If a client experiences diaphoresis, warmth, and a backache, a transfusion reaction is suspected. The nurse stops the transfusion and prevents the infusion of any additional blood; then the nurse hangs a bag of 0.9% sodium chloride solution. This maintains IV access and helps maintain the client's intravascular volume. The primary health care provider is notified, as is the blood bank. The nurse also documents the occurrence, the actions taken, and the client's response. To preserve the IV access, the nurse should not remove the catheter and discontinue the IV site.
The nurse is preparing a teaching plan for a 45-year-old client recently diagnosed with type 2 diabetes mellitus. What is the first step in this process?
- A. Establish goals.
- B. Assess the client's learning needs.
- C. Set priorities of learning needs.
- D. Select teaching strategies.
Correct Answer: B
Rationale: Assessing the client's learning needs is the first step to tailor education to their knowledge level, preferences, and barriers, ensuring effective teaching.
A family has taken home their newborn and later received a call from the pediatrician that the PKU levels for their newborn daughter are abnormally high. Additional testing confirmed the diagnosis of phenylketonuria. The parents refuse to believe the results as no one else in their family has the disease. The nurse explains that the disease:
- A. Is carried on recessive genes contributed by each parent.
- B. Is caused by a recessive gene contributed by either parent.
- C. Is cured by eliminating dietary protein for this child.
- D. Will not impact future childbearing for the family.
Correct Answer: A
Rationale: Phenylketonuria is an autosomal recessive disorder, requiring both parents to contribute a defective gene. It is not caused by a single parent's gene, cannot be cured by diet alone (though managed by low-phenylalanine diet), and may impact future childbearing as parents are carriers.