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Which teaching instructions should the nurse reinforce to a client with advanced chronic obstructive pulmonary disease?
- A. Follow a low-calorie diet
- B. Obtain a pneumococcal vaccine
- C. Report increased sputum
- D. Take iron to improve anemia
- E. Use an incentive spirometer
Correct Answer: B,C,E
Rationale: Pneumococcal vaccine (B), reporting increased sputum (C), and incentive spirometry (E) manage COPD. A high-calorie diet, not low-calorie (A), is needed. Iron (D) is only indicated for confirmed anemia.
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The nurse is teaching a client newly diagnosed with asthma how to use the metered-dose inhaler (MDI). The client asks when they will know the canister is empty. The best response is
- A. Drop the canister in water to observe floating
- B. Estimate how many doses are usually in the canister
- C. Count the number of doses as the inhaler is used
- D. Shake the canister to detect any fluid movement
Correct Answer: A
Rationale: Dropping the canister into a bowl of water assesses the amount of medication remaining in a metered-dose inhaler. The client should obtain a refill when the inhaler rises to the surface and begins to tip over.
The nurse is caring for a woman who has internal radiation for cancer of the cervix. Which of the following situations poses the greatest risk for others?
- A. The client's daughter spends several hours sitting next to the client's bed.
- B. The client's husband kisses her and visits for five minutes before leaving.
- C. The nurse brings the client her lunch tray and sets it up on the overbed table for her.
- D. The cleaning lady damp mops the room.
Correct Answer: A
Rationale: Prolonged close contact (daughter's hours-long visit) increases radiation exposure risk. Brief visits, tray setup, or mopping pose minimal risk.
The nurse is observing a nursing assistant move a client from bed to chair. Which action by the nursing assistant indicates a lack of understanding about transfer techniques?
- A. Bending from the waist when moving the person
- B. Keeping the feet separated when lifting and moving the person
- C. Turning the whole body when moving the person to the chair
- D. Asking for help in moving the person from bed to chair
Correct Answer: A
Rationale: Bending from the waist risks back injury, indicating improper technique. Wide stance, whole-body turning, and seeking help are correct.
The nurse in the mental health unit is talking with several clients during group therapy. A client becomes angry and throws a fire extinguisher at another client. Which of the following actions would be a priority for the nurse to take?
- A. Activate the rapid response team.
- B. Approach the client calmly and acknowledge the client's feelings.
- C. Escort other clients away from the area.
- D. Inform the client that the action was dangerous and unacceptable.
Correct Answer: C
Rationale: Ensuring safety by escorting others away (C) is the priority. Rapid response (A) may be premature, approaching the client (B) risks escalation, and informing of consequences (D) is secondary.
A client with a 10-year history of major depressive disorder has relapsed and is now hospitalized. The client is currently on phenelzine and weighs 115 lb (52.2 kg) but weighed 150 lb (68 kg) 3 months before admission. Which foods would be best for this client?
- A. Crackers and cheddar cheese
- B. Hard-boiled egg with tomatoes
- C. Steamed fish and potatoes
- D. Tortilla chips with avocado dip
Correct Answer: C
Rationale: Phenelzine, an MAOI, requires avoiding tyramine-rich foods like cheese (A) to prevent hypertensive crisis. Fish and potatoes (C) are safe and nutritious. Eggs (B) and avocado (D) are safe but less balanced.