Nokea
The school nurse teaches an athletic coach how to prevent dehydration among athletes practicing in the hot weather. What is the best advice for the nurse to give to the coach?
- A. Drink plenty of fluids before and after practice.
- B. Have the athletes take a salt tablet before practice.
- C. Reschedule practice for before school and after sunset.
- D. Provide a fluid break every 30 minutes during practice.
Correct Answer: D
Rationale: Hot weather accelerates the body's loss of fluid and electrolytes during strenuous physical activity, so the nurse encourages the coach to schedule fluid breaks at 30-minute intervals so that the athletes can periodically rest and restore body fluids. Drinking fluid before and after practice is a reasonable suggestion; however, because the hot weather accelerates fluid and electrolyte losses, body fluids must be periodically replenished to maintain the fluid and electrolyte balance. Although a sodium load increases fluid retention, the nurse avoids suggesting salt tablets for the athletes because the nurse needs approval from each athlete's primary health care provider before recommending the salt. Rescheduling practice times is unrealistic.
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The mother of a teenage client diagnosed with an anxiety disorder is concerned about her daughter's progress after discharge. She states that her daughter 'stashes food, eats all the wrong things that make her hyperactive,' and 'hangs out with the wrong crowd.' To assist the mother with preparing for her daughter's discharge, the nurse advises the mother to implement which action in order to promote optimal health?
- A. Restrict the daughter's socializing time with her school friends.
- B. Consider taking time off to help her daughter readjust to the home environment.
- C. Limit the amount of chocolate and caffeine products that are available in the home.
- D. Keep her daughter out of school until she proves that she can adjust to the school environment.
Correct Answer: C
Rationale: Limiting chocolate and caffeine reduces anxiety triggers in clients with anxiety disorders. Restricting socializing, taking time off work, or keeping her out of school are impractical or unhealthy, hindering social and emotional adjustment.
The nurse is performing an assessment on a primigravida client who has been a marathon runner for several years. The client verbalizes concern because she is no longer able to run in marathons and is concerned about the brown discoloration on her face and her increasing size. Which statements by the nurse are therapeutic?
- A. I can see you're disappointed at not being able to run.
- B. Tell me how you are feeling about the changes in your body.
- C. Don't worry. Your body will go back to normal after delivery.
- D. You need to ask your obstetrician about whether or not you can run.
- E. Wait and see. You will be back to marathon running after delivery before you know it.
- F. Some of the changes in pregnancy are permanent and that is the price that you have to pay for that bundle of joy.
Correct Answer: A,B
Rationale: The client is concerned about the body changes and life changes being experienced as a result of pregnancy. Therapeutic communication techniques include focusing on the client's feelings and concerns and acknowledging these concerns by the techniques of clarifying and encouraging discussion of feelings. Telling a client 'not to worry,' placing the client's feelings on hold, and avoiding discussion of the client's feelings are nontherapeutic communication techniques.
A client being discharged to home after angioplasty via the right femoral groin has received the catheter insertion site discharge instructions from the nurse. Which client statement indicates that the client understands the instructions?
- A. Coolness or discoloration of the right foot is expected.
- B. I should expect a large area of bruising at the right groin.
- C. Temperature as high as 101°F (38.3°C) is not unusual a few days after the procedure.
- D. Mild discomfort in the right groin may occur, and Tylenol should relieve the pain.
Correct Answer: D
Rationale: The client may feel some mild discomfort at the catheter insertion site after angioplasty. This is usually relieved by analgesics such as acetaminophen (Tylenol). The client is taught to report to the primary health care provider any neurovascular changes to the affected leg; bleeding or bruising at the insertion site; and signs/symptoms of local infection, such as drainage at the site or increased temperature.
A community health nurse is lecturing students at a nearby community college about high-risk behavior. Which of the following should the nurse include in the lecture?
- A. Suicide is the most common cause of death in this age group.
- B. Cancer is the third most common cause of death in this age group.
- C. Homicide is the second most common cause of death in this age group.
- D. College-age students are more likely to die from unintentional injuries.
Correct Answer: D
Rationale: Unintentional injuries (e.g., car accidents) are the leading cause of death in college-age students. Suicide and homicide rank lower, and cancer is not third.
The nurse is monitoring a client diagnosed with type 1 diabetes mellitus. Today's blood work reveals a glycosylated hemoglobin level of 10%. The nurse creates a teaching plan based on the understanding that this result indicates which finding?
- A. A normal value that indicates that the client is managing blood glucose control well
- B. A value that does not offer information regarding the client's management of the disease
- C. A low value that indicates that the client is not managing blood glucose control very well
- D. A high value that indicates that the client is not managing blood glucose control very well
Correct Answer: D
Rationale: Glycosylated hemoglobin is a measure of glucose control during the 6 to 8 weeks before the test. It is a reliable measure for determining the degree of glucose control in diabetic clients over a period of time, and it is not influenced by dietary management 1 to 2 days before the test is done. The glycosylated hemoglobin level should be 6.0% or less for a client diagnosed with diabetes mellitus, with elevated levels indicating poor glucose control.