A nurse is discussing good food choices with a client who is recovering from an exacerbation of inflammatory

A nurse is discussing good food choices with a client who is recovering from an exacerbation of inflammatory bowel disease and is to start a low-lactose diet. Which of the following foods is the best choice for the client?

1.

• Soy milk
• Cheddar cheese
• Low-fat yogurt
• Cottage cheese

A nurse is planning care for an older adult client who is at high risk for developing pressure ulcers. Which of the following is an appropriate measure for the nurse to include?

2.

• Use a draw sheet to move the client up in bed.
• Apply cornstarch to keep sensitive skin areas dry.
• Massage the skin over the client’s bony prominences.
• Elevate the head of the bed no more than 45 degrees.

A nurse is caring for a client who has developed atelectasis first day postoperatively. Which of the following is an expected finding?

3.

• Apnea
• Dysphagia
• Hypoxemia
• Pleural effusion

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A nurse is providing dietary teaching to an Asian-American client who is gazing at the floor during the instruction. Which of the following actions would demonstrate culturally sensitive nursing care?

4.

• Stopping the instructions to assess the floor
• Emphasizing the significance of the information
• Moving closer to the client for eye contact
• Continuing with the discussion

A nurse is providing teaching to a client who is scheduled for a bowel resection. Which of the following statements by the client indicates to the nurse a need for further teaching?

5.

• “I will take my docusate (Colace) with a glass of water the morning of surgery.”
• “I have been practicing how to cough.”
• “I listened to the audiotape you sent home with me.”
• “I will take time to relax if I get nervous the night before surgery.”

A nurse is implementing a bowel training program for a client. For the program to be effective the client should be taken to the bathroom at which of the following times?

6.

• When the client has the urge to defecate.
• Every 2 hr while the patient is awake.
• Immediately before meals.
• After client feels abdominal cramping.

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A client who has emphysema and has difficulty with mobility is receiving home health care. He spends most of his day in a reclining chair. Which physiological response to prolonged immobility should the nurse expect?

7.

• Increased insulin production
• Decreased RBC production
• Decreased sodium excretion
• Increased calcium excretion

A nurse is planning preventive care for a client who has pressure ulcers and is confined to bed. Which of the following is an appropriate nursing action?

8.

• Massage the client’s red bony prominences.
• Palpate the client’s skin for increased coolness.
• Reposition the client every 2 hr.
• Keep the client’s skin moist.

A nurse is instructing a group of adults regarding nutrition. The nurse's teaching should include which of the following as an appropriate daily intake of fiber?

9.

• 5 to 10 g
• 10 to 15 g
• 20 to 35 g
• 40 to 50 g

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A nurse is discussing indications for the use of urinary catheterization with a newly licensed nurse. Which of following should the nurse identify as an appropriate indication? (Select all that apply).

10.

• Relief of urinary retention.
• Convenience for the nursing staff or client’s family.
• Measurement of residual urine after urination.
• Routine acquisition of a urine specimen.
• Presence of an open perineal wound.

An older adult client in a long-term care facility had a cerebrovascular accident (CVA) 4 weeks ago and has been unable to move independently since that time. The nurse caring for her should observe for which of the following findings that indicates a complication of immobility?

11.

• A reddened area over the sacrum
• Stiffness in the lower extremities
• Difficulty moving the upper extremities
• Difficulty hearing some types of sounds

A nurse is discussing urinary tract infections (UTI) with a client. Which of the following should the nurse include as a risk factor?

12.

A. COPD.

• Diabetes mellitus.
• Anemia.
• Osteoporosis.

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