Which medication should a patient with a history of peptic ulcer disease avoid?
- A. Acetaminophen
- B. Antacids
- C. Nonsteroidal anti-inflammatory drugs
- D. Antihistamines
Correct Answer: C
Rationale: Patients with a history of peptic ulcer disease should avoid Nonsteroidal anti-inflammatory drugs (NSAIDs) because they can worsen peptic ulcers due to their effects on the stomach lining. Acetaminophen (Choice A) is a safer alternative for pain relief in such patients as it does not have the same ulcerogenic effects. Antacids (Choice B) can actually help alleviate symptoms by neutralizing stomach acid and are generally safe to use. Antihistamines (Choice D) are not known to exacerbate peptic ulcers and can be used safely for conditions like allergies.
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What is the best position to measure the leg circumference of a client with bipedal edema?
- A. Dorsal recumbent
- B. Sitting
- C. Standing
- D. Supine
Correct Answer: A
Rationale: When measuring the leg circumference of a client with bipedal edema, the best position to ensure accurate and consistent measurements is the dorsal recumbent position. This position allows the legs to be comfortably positioned, with the individual lying on their back and legs extended. This facilitates accurate measurement of the circumference without the influence of gravity. Sitting and standing positions may not provide optimal conditions for accurate leg circumference measurements as they may not allow the legs to be fully extended. The supine position, although similar to dorsal recumbent, may not provide the same level of comfort and accuracy in leg circumference measurement for a client with bipedal edema.
The client is diagnosed with pericarditis. When assessing the client, the nurse is unable to auscultate a friction rub. Which action should the nurse implement?
- A. Notify the healthcare provider
- B. Document that the pericarditis has resolved
- C. Ask the client to lean forward and listen again
- D. Prepare to insert a unilateral chest tube
Correct Answer: C
Rationale: The correct action for the nurse to implement when unable to auscultate a pericardial friction rub in a client diagnosed with pericarditis is to ask the client to lean forward and listen again. Leaning forward can help bring the heart closer to the chest wall, making it easier to detect the rub. Option A (Notifying the healthcare provider) is incorrect because further assessment is needed before escalating the situation. Option B (Documenting that the pericarditis has resolved) is incorrect as the absence of a friction rub does not necessarily mean resolution. Option D (Preparing to insert a unilateral chest tube) is incorrect as this intervention is not indicated for the absence of a friction rub.
When assessing a client for an endocrine dysfunction, which question should the nurse ask?
- A. "Have you noticed any pain in your legs when walking?"
- B. "Have you had any unexplained weight loss?"
- C. "Have you noticed any change in your bowel movements?"
- D. "Have you experienced any joint pain or discomfort?"
Correct Answer: B
Rationale: The correct answer is B: "Have you had any unexplained weight loss?" Unexplained weight loss can be a common symptom of various endocrine disorders, such as hyperthyroidism and diabetes. This weight loss is often despite an adequate or increased appetite. Choices A, C, and D are less likely to be directly associated with endocrine dysfunction. Pain in the legs when walking could be related to musculoskeletal issues, changes in bowel movements may suggest gastrointestinal concerns, and joint pain is more commonly linked to rheumatologic conditions rather than primary endocrine disorders.
The nurse is caring for a client whose religious background is Seventh Day Adventist (Church of GOD). Which nursing action(s) are most appropriate in terms of providing for the dietary needs of this client? Select all that apply.
- A. Providing snacks between meals
- B. Removing coffee from the breakfast tray
- C. Ensuring that there is no pork on the dinner tray
- D. A, B
Correct Answer: D
Rationale: Seventh Day Adventists typically avoid caffeine and pork, so providing snacks between meals and removing coffee from the breakfast tray are appropriate actions to meet the dietary needs of this client. Providing snacks helps ensure the client has options that align with their dietary restrictions, while removing coffee respects their avoidance of caffeine. Ensuring that there is no pork on the dinner tray is also crucial as pork is typically avoided in their diet, making choice C correct. Therefore, choices A and B are correct, making D the most appropriate selection.
A client has been given instructions about ferrous sulfate. Which statement made by the client would indicate the client needs further education?
- A. "I will take this medication with a full glass of milk."
- B. "I will take the morning dose 1 hour before breakfast."
- C. "I will need to avoid taking this medication with coffee."
- D. "I will take antacids if needed, 2 hours after I take ferrous sulfate."
Correct Answer: A
Rationale: The correct answer is A. Ferrous sulfate should not be taken with milk as it can impair iron absorption. Choice B is correct as taking the morning dose 1 hour before breakfast is appropriate. Choice C is correct as coffee can interfere with iron absorption. Choice D is correct as antacids should be taken 2 hours after ferrous sulfate to avoid interference with its absorption.