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The physician has ordered a low-potassium diet for a client with renal failure. Which food should be limited due to its potassium content?
- A. Broccoli
- B. Bananas
- C. Lean beef
- D. White rice
Correct Answer: B
Rationale: Bananas, with ~400-450 mg potassium per fruit, must be limited on a low-potassium diet in renal failure, as impaired kidneys can't excrete excess, risking hyperkalemia broccoli's moderate, beef and rice's low potassium fit better. Nurses teach this, preventing cardiac issues, tailoring diets for renal safety.
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Type of recording that integrates all data about the problem, gathered by members of the health team.
- A. POMR
- B. Traditional
- C. Resource oriented
- D. Source oriented
Correct Answer: A
Rationale: POMR (Problem-Oriented Medical Record) (A) integrates team data per problem, per Weed's system. Traditional (B) and source-oriented (D) separate by discipline. Resource-oriented (C) isn't recognized. A fits interdisciplinary focus, making it correct.
After a day, Mr Gary's wife shouted at the nurse and said 'You're not doing your job right! My husband is dying because of you!' This is an example of?
- A. Denial
- B. Anger
- C. Bargaining
- D. Depression
Correct Answer: B
Rationale: Shouting 'You're not doing your job is anger (B), per Kubler-Ross lashing out in grief. Denial (A) rejects, bargaining (C) pleads, depression (D) withdraws. Anger targets others, fitting her outburst, making it correct.
When working as a licensed vocational nurse, you determine that your client scheduled for surgery does not understand the physician's earlier explanation of the surgery. The client is asking many questions about the risks and seems worried. Which of the following actions would be best on your part?
- A. Quickly explain the surgery procedures and the risks to the client.
- B. Cancel the surgery.
- C. Ask your supervising RN to explain the surgery procedure and its risks.
- D. Notify the physician.
Correct Answer: D
Rationale: When a client scheduled for surgery shows a lack of understanding and expresses concern, notifying the physician is the best action for a licensed vocational nurse. The physician, as the primary decision-maker and the one obtaining informed consent, has the responsibility to ensure the client fully comprehends the procedure, risks, and benefits. The nurse's role is to facilitate communication and advocate for the client's needs, not to independently explain complex medical details outside their scope or cancel the surgery, which exceeds their authority. Asking the supervising RN might help, but it delays direct resolution by the physician, who is legally accountable for ensuring consent is informed. This approach upholds the nurse's duty to prioritize client understanding and safety while respecting professional boundaries and legal standards.
The physician has discussed the need for medication with the parents of an infant with congenital hypothyroidism. The nurse can reinforce the physician's teaching by telling the parents that:
- A. The medication will be needed only during times of rapid growth
- B. The medication will be needed throughout the child's lifetime
- C. The medication schedule can be arranged to allow for drug holidays
- D. The medication is given one time daily every other day
Correct Answer: B
Rationale: Lifetime thyroid hormone replacement is needed for congenital hypothyroidism to prevent developmental delays growth spurts, holidays, or alternate days don't suffice. Nurses reinforce this, ensuring adherence, critical for normal growth in this endocrine disorder.
The nurse is suctioning a client through a tracheostomy tube. During the procedure, the client begins to cough, and the nurse notes the presence of an audible wheeze. The nurse attempts to remove the suction catheter from the client's trachea but is unable to do so. What is the nurse's priority response?
- A. Call a code.
- B. Administer a bronchodilator.
- C. Contact the health care provider.
- D. Disconnect the suction source from the catheter.
Correct Answer: D
Rationale: A stuck catheter with coughing and wheezing suggests obstruction or bronchospasm; disconnecting the suction source (D) is the priority to relieve pressure and attempt removal. Calling a code (A) or provider (C) delays action. Bronchodilators (B) treat wheezing but not the immediate issue. D is correct. Rationale: Disconnecting stops suction trauma, allowing catheter withdrawal and airway reassessment, a critical first step per emergency airway protocols.