Nokea
Which snack selection by a client with osteoporosis indicates that the client understands the dietary management of the disease?
- A. A granola bar
- B. A bran muffin
- C. Yogurt
- D. Raisins
Correct Answer: C
Rationale: Yogurt is rich in calcium, which is essential for bone health in osteoporosis management.
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The nurse is assessing a client with suspected meningitis. Which of the following findings would the nurse expect?
- A. Positive Kernig’s sign.
- B. Hypothermia.
- C. Soft, non-tender neck.
- D. Decreased level of consciousness.
Correct Answer: A
Rationale: positive Kernig’s sign (pain and resistance on leg extension) is a classic finding in meningitis
A nurse is working in a residential facility when a fire breaks out in one hallway. The nurse and an elderly client are trapped in the client's room and cannot get out. The nurse should
- A. crawl in the closet with the client and shut the door.
- B. open a window in the client's room.
- C. instruct the client to crawl under the bed.
- D. leave the door to the room open.
Correct Answer: B
Rationale: Opening a window provides ventilation and a potential escape route while avoiding smoke inhalation. Keeping the door closed prevents smoke entry, and crawling under the bed or in a closet is unsafe.
The nurse is developing a plan of care for a client with an ileostomy. The priority nursing diagnosis is:
- A. Fluid volume deficit
- B. Alteration in body image
- C. Impaired oxygen exchange
- D. Alteration in elimination
Correct Answer: A
Rationale: Fluid volume deficit is the priority due to the risk of dehydration from high ileostomy output, which can lead to electrolyte imbalances and other complications.
The nurse is caring for a client hospitalized with bipolar disorder, manic phase who is taking lithium. Which of the following snacks would be best for the client with mania?
- A. Potato chips
- B. Diet cola
- C. Apple
- D. Milkshake
Correct Answer: C
Rationale: An apple is a healthy, low-sodium snack, suitable for a client on lithium, as high sodium foods like potato chips can affect lithium levels.
Which assignment should not be performed by the nursing assistant?
- A. Feeding the client
- B. Bathing the client
- C. Obtaining a stool
- D. Administering a fleet enema
Correct Answer: D
Rationale: Administering an enema is an invasive procedure requiring clinical judgment, which is beyond the scope of a nursing assistant's responsibilities.