Nokea
Which of the following would be an expected outcome for a client with peptic ulcer disease? The client will:
- A. Demonstrate appropriate use of analgesics to control pain.
- B. Explain the rationale for eliminating alcohol from the diet.
- C. Verbalize the importance of monitoring hemoglobin and hematocrit every 3 months.
- D. Eliminate contact sports from his or her lifestyle.
Correct Answer: B
Rationale: Eliminating alcohol is critical for clients with peptic ulcer disease, as it irritates the gastric mucosa and can exacerbate symptoms. The other options are less directly related to the management of peptic ulcer disease.
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The physician prescribes metoclopramide hydrochloride (Reglan) for the client with hiatal hernia. The nurse plans to instruct the client that this drug is used in hiatal hernia therapy to accomplish which of the following objectives?
- A. Increase tone of the esophageal sphincter.
- B. Neutralize gastric secretions.
- C. Ease gastric emptying.
- D. Reduce secretion of digestive juices.
Correct Answer: C
Rationale: Metoclopramide promotes gastric emptying, reducing the volume of gastric contents that can reflux in hiatal hernia.
Which of the following statements would indicate to the nurse that the client who has undergone repair of her nasal septum has understood the discharge instructions?
- A. I should not shower until my packing is removed.
- B. I will take stool softeners and modify my diet to prevent constipation.
- C. Coughing every 2 hours is important to prevent respiratory complications.
- D. It is important to blow my nose each day to remove the dried secretions.
Correct Answer: B
Rationale: Taking stool softeners and modifying the diet to prevent constipation avoids straining (Valsalva's maneuver), which could cause bleeding or complications post-nasal surgery.
The nurse is instructing a young adult with Addison's disease how to adjust the dose of glucocorticoids. The nurse should explain that the client may need an increased dosage of glucocorticoids in which of the following situations?
- A. Completing the spring semester of school.
- B. Gaining 4 pounds.
- C. Becoming engaged.
- D. Undergoing a root canal.
Correct Answer: D
Rationale: Stressful situations like surgery or dental procedures (e.g., root canal) increase glucocorticoid needs in Addison's disease to prevent adrenal crisis.
A client has been admitted with acute renal failure. What should the nurse do? Select all that apply.
- A. Elevate the head of the bed 30 to 45 degrees.
- B. Take vital signs.
- C. Establish an I.V. access site.
- D. Call the admitting physician for orders.
- E. Contact the hemodialysis unit.
Correct Answer: B,C,D
Rationale: Taking vital signs, establishing IV access, and contacting the physician are immediate actions to assess and stabilize the client with acute renal failure.
The nurse is teaching the client and family how to manage possible nausea and vomiting at home. The nurse should include information about:
- A. Eating frequent, small meals throughout the day.
- B. Eating three normal meals a day.
- C. Eating only cold foods with no odor.
- D. Limiting the amount of fluid intake.
Correct Answer: A
Rationale: Eating frequent, small meals helps prevent nausea by avoiding an empty or overly full stomach, which can trigger vomiting during chemotherapy.