Nokea
The physician has ordered a low-residue diet for a client with Crohn's disease. Which food is not permitted in a low-residue diet?
- A. Mashed potatoes
- B. Smooth peanut butter
- C. Fried fish
- D. Rice
Correct Answer: C
Rationale: Fried fish is high in fat and residue, which can exacerbate symptoms in Crohn's disease; low-residue diets emphasize easily digestible foods.
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The nurse is assigned to care for the client with a Steinmen pin. During pin care, she notes that the LPN uses sterile gloves and Q-tips to clean the pin. Which action should the nurse take at this time?
- A. Assisting the LPN with opening sterile packages and peroxide
- B. Telling the LPN that clean gloves are allowed
- C. Telling the LPN that the registered nurse should perform pin care
- D. Asking the LPN to clean the weights and pulleys with peroxide
Correct Answer: A
Rationale: Sterile technique is appropriate for pin care; assisting maintains the sterile field.
The physician has prescribed imipramine (ToFranil) for a client with depression. The nurse should continue to monitor the client's affect because the maximal effects of tricyclic antidepressant medication do not occur for:
- A. 48-72 hours
- B. 5-7 days
- C. 2-4 weeks
- D. 3-6 months
Correct Answer: C
Rationale: Tricyclic antidepressants like imipramine take 2-4 weeks to reach maximal therapeutic effect, requiring ongoing monitoring of the client's mood.
The nurse is making initial rounds on a client with a C5 fracture and crutchfield tongs. Which equipment should be kept at the bedside?
- A. A pair of forceps
- B. A torque wrench
- C. A pair of wire cutters
- D. A screwdriver
Correct Answer: B
Rationale: A torque wrench is needed to adjust and maintain the tension of crutchfield tongs for cervical stabilization.
The nurse is caring for a client with an endemic goiter. The nurse recognizes that the client's condition is related to:
- A. Living in an area where the soil is depleted of iodine
- B. Eating foods that decrease the thyroxine level
- C. Using aluminum cookware to prepare the family's meals
- D. Taking medications that decrease the thyroxine level
Correct Answer: A
Rationale: Endemic goiter is caused by iodine deficiency, often due to low iodine levels in soil, leading to inadequate thyroid hormone production.
The nurse is admitting a client with a diagnosis of severe malignant catatonia to the in-patient psychiatric unit. Under which condition would the nurse support the use of electroconvulsive therapy (ECT) as a first-line treatment?
- A. The client is in the first trimester of pregnancy.
- B. The client is gainfully employed.
- C. The client lives in an assisted living facility.
- D. The client is over 50 years of age.
Correct Answer: C
Rationale: ECT may be considered first-line for severe malignant catatonia in a controlled setting like an assisted living facility, where monitoring is feasible. Pregnancy and age are contraindications or require caution, and employment is irrelevant.