Nokea
To reduce the possibility of having a baby with a neural tube defect, the client should be told to increase her intake of folic acid. Dietary sources of folic acid include:
- A. Meat, liver, eggs
- B. Pork, fish, chicken
- C. Spinach, beets, cantaloupe
- D. Dried beans, sweet potatoes, Brussels sprouts
Correct Answer: D
Rationale: Folic acid is found in foods like dried beans, sweet potatoes, and Brussels sprouts. These help reduce the risk of neural tube defects like spina bifida when consumed before and during early pregnancy.
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The nurse has given instructions on pursed-lip breathing to a client with COPD. Which statement by the client would indicate effective teaching?
- A. I should inhale through my mouth.'
- B. I should tighten my abdominal muscles with inhalation.'
- C. I should contract my abdominal muscles with exhalation.'
- D. I should make inhalation twice as long as exhalation.'
Correct Answer: C
Rationale: Pursed-lip breathing involves inhaling through the nose and exhaling slowly through pursed lips, which may involve contracting abdominal muscles to assist with exhalation, prolonging exhalation to reduce air trapping in COPD.
A client with AIDS has a viral load of 200 copies per ml. The nurse should interpret this finding as:
- A. The client is at risk for opportunistic diseases.
- B. The client is no longer communicable.
- C. The client's viral load is extremely low so he is relatively free of circulating virus.
- D. The client's T-cell count is extremely low.
Correct Answer: C
Rationale: A viral load of 200 copies/ml is low, indicating effective treatment and minimal circulating virus.
The nurse is caring for the client with a 5-year-old diagnosis of plumbism. Which information in the health history is most likely related to the development of plumbism?
- A. The client has traveled out of the country in the last 6 months.
- B. The client's parents are skilled stained-glass artists.
- C. The client lives in a house built in 1990.
- D. The client has several brothers and sisters.
Correct Answer: B
Rationale: Stained-glass work often involves lead, increasing the risk of lead poisoning (plumbism).
Which of the following medication orders requires clarification before the nurse can administer the order?
- A. epinephrine (EpiPen) 0.25 mg IM STAT
- B. heparin 30 units/kg/hr IV infusion for 24 hours
- C. ampicillin (Omnipen) 500 mg PO bid
- D. lorazepam (Ativan) 1.0 mg PO prn
Correct Answer: B
Rationale: Heparin dosing (30 units/kg/hr) is unusually low for anticoagulation (typically 10-20 units/kg/hr). This requires clarification to ensure safety.
The nurse is caring for a client with bulimia nervosa. The nurse recognizes that the major difference in the client with anorexia nervosa and the client with bulimia nervosa is the client with bulimia:
- A. Is usually grossly overweight.
- B. Has a distorted body image.
- C. Recognizes that she has an eating disorder.
- D. Struggles with issues of dependence versus independence.
Correct Answer: C
Rationale: Clients with bulimia often recognize their eating disorder, unlike those with anorexia, who may deny the problem due to distorted body image.