Nokea
The physician has recommended that the client increase the amount of dietary iron. The nurse knows that the client understands the recommendation when the client selects which foods?
- A. Orange juice, scrambled eggs, and toast
- B. Hot dog and roll, French fries, and cola
- C. Roast beef, carrots, and rice
- D. Baked chicken, peas, and noodles
Correct Answer: C
Rationale: Roast beef is high in iron, suitable for increasing dietary iron. Other options lack significant iron sources.
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A client is scheduled for a myelogram. Which of the following medications orders should be questioned?
- A. Ampicillin (Pencipen) $250 \mathrm{mg} \mathrm{PO} \mathrm{q} 6$ hours
- B. Motrin (Ibuprofen) $400 \mathrm{mg} \mathrm{PO} \mathrm{q} 4$ hours PRN for headache
- C. Secobarbital (Seconal) $50 \mathrm{mg}$ HS PRN for sleep
- D. Propoxyphene (Darvon) $65 \mathrm{mg} \mathrm{PO} \mathrm{q} 4$ hours for pain
Correct Answer: B
Rationale: Ibuprofen (Motrin) has anticoagulant properties, increasing bleeding risk during a myelogram, a procedure involving spinal puncture. Other medications are safer.
The nurse is caring for a client who had a right modified radical mastectomy 4 hours ago. The nurse should place the client in the
- A. high Fowler position with the right arm resting on the bed
- B. supine position with the right arm elevated on several pillows
- C. semi-Fowler position with the right arm elevated on several pillows
- D. supine position with the right arm resting on the bed
Correct Answer: C
Rationale: Semi-Fowler position with the right arm elevated promotes drainage and reduces edema post-mastectomy. High Fowler may strain the incision, and supine without elevation (B, D) increases edema risk.
The nurse has just received the shift report. Which one of the following clients should be seen first?
- A. A 14-year-old one day post-appendectomy with a WBC of 6500
- B. A 5-year-old three days post-fracture of the right tibia with a temperature of 101° Fahrenheit
- C. An 11-month-old admitted during the previous shift with dehydration and a hematocrit of 40
- D. An 8-week-old admitted four hours earlier with sub-sternal retractions and an oxygen saturation of 90%
Correct Answer: D
Rationale: Answer D is correct. There is nothing in answer A that indicates the client is unstable. Answer B is a good choice, but the client three days post-fracture may have a slight temperature, so he should be seen second. Answer C is also a good choice, but if the infant with dehydration is stable, the 8-week-old with respiratory distress (sub-sternal retractions and low oxygen saturation) is the most critical and should be seen first.
The nurse is repairing new prescriptions from the health care provider. Which prescription would require further clarification?
- A. Atorvastatin for hyperlipidemia in a client with angina pectoris
- B. Bupropion for smoking cessation in a client with emphysema
- C. Cyclobenzaprine for muscle spasms in a client with hepatitis
- D. Metronidazole for trichomoniasis in a client with Crohn disease
Correct Answer: C
Rationale: Cyclobenzaprine is contraindicated in hepatic impairment due to hepatitis, as it is metabolized by the liver, requiring clarification. Other prescriptions (A, B, D) are appropriate for the conditions.
The nurse in a clinic is caring for an 8-month-old client with a new diagnosis of bronchiolitis due to respiratory syncytial virus. Which of the following instructions should the nurse provide to the parent?
- A. Administration of a cough suppressant and an antihistamine
- B. Prophylactic treatment of family members
- C. Temporary cessation of breastfeeding
- D. Use of saline drops and a bulb syringe to suction nares
Correct Answer: D
Rationale: For bronchiolitis due to RSV, saline drops and bulb syringe suctioning help clear nasal passages, improving breathing. Cough suppressants and antihistamines are not recommended as they may suppress necessary cough or cause sedation. Prophylactic treatment is not standard for family members unless immunocompromised, and breastfeeding should continue to provide antibodies.