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Which of the following is an expected finding in the assessment of a client with bulimia nervosa?
- A. Extreme weight loss
- B. Presence of lanugo over body
- C. Erosion of tooth enamel
- D. Muscle wasting
Correct Answer: C
Rationale: Bulimia nervosa involves recurrent binge eating followed by purging, often through vomiting, which exposes teeth to stomach acid, leading to enamel erosion. Extreme weight loss and lanugo are more characteristic of anorexia nervosa, and muscle wasting is not a primary feature of bulimia.
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A client with a history of a tonsillectomy is being discharged. The nurse should teach the client to:
- A. Gargle with warm salt water
- B. Avoid cold liquids
- C. Report excessive swallowing
- D. Use a straw for fluids
Correct Answer: C
Rationale: Excessive swallowing post-tonsillectomy may indicate bleeding, a serious complication requiring immediate reporting. Gargling, cold liquids, and straws may irritate the surgical site.
The nurse is caring for a client who has had a tracheostomy for 7 years. The client is started on a full-strength tube feeding at 75 mL/hr. Prior to starting the tube feeding, the nurse confirms placement of the tube in the stomach. The hospital policy states that all tube feeding must be dyed blue. On suctioning, the nurse notices the sputum to be a blue color. This is indicative of which of the following?
- A. The client aspirated tube feeding.
- B. The nurse has placed the suction catheter in the esophagus.
- C. This is a normal finding.
- D. The feeding is infusing into the trachea.
Correct Answer: A
Rationale: Once the feeding tube placement is confirmed in the stomach, aspiration can occur if the client's stomach becomes too full. When suctioning the trachea, if secretions resemble tube feeding, the client has aspirated the feeding.
The nurse is observing a student gauss administering ear drops to a two-year-old. Which observation by the nurse would indicate correct technique?
- A. Holds the child's head up and extended
- B. Places the head in chin-tuck position
- C. Pulls the pinna down and back
- D. Irrigates the ear before administering medication
Correct Answer: C
Rationale: Pulling the pinna down and back in children straightens the ear canal for proper ear drop administration. Head extension (A), chin-tuck (B), and irrigation (D) are incorrect.
The physician has ordered synthetic thyroid medication for a patient with hypothyroidism. The nurse should instruct the client to:
- A. Take the medication with food to prevent nausea
- B. Take the medication at bedtime
- C. Take the medication in the morning with water
- D. Take the medication with the evening meal
Correct Answer: C
Rationale: Thyroid medication (e.g. levothyroxine) is best taken in the morning on an empty stomach with water to optimize absorption and align with the body’s circadian rhythm. Taking it with food or at other times may reduce efficacy.
The nurse is caring for a client who has diabetes insipidus. The nurse would describe this client's urine output pattern as:
- A. Anuria
- B. Oliguria
- C. Dysuria
- D. Polyuria
Correct Answer: D
Rationale: Polyuria is a primary symptom of diabetes insipidus. These clients have decreased or absent vasopressin secretion, which causes water loss in the urine and sodium increases.