NU 301:NCLEX Challenge 6

NU 301:NCLEX Challenge 6 A nurse is planning care for a client who has diverticulitis. Which of the following menu selections should the nurse include in the plan? Grilled chicken breast with white rice A nurse is caring for a child who has acute gastroenteritis but is able to tolerate oral fluids. The nurse should anticipate providing which of the following type of fluid? Oral rehydration solution A nurse is teaching a client who has a new prescription for esomeprazole to manage his GERD. Which of the following statements by the client indicates an understanding of the teaching? “I have an increased risk of getting pneumonia while taking this medication.” A nurse is teaching a client who has a hiatal hernia about dietary recommendations. Which of the following client statements indicates an understanding of the teaching? (Select all that apply.) “I will consume less caffeine and fewer spicy foods.” “I will sleep with the head of my bed elevated.” “I will try not to gain weight.” A nurse is working with an assistive personnel (AP) while caring for a surgical client who is 1 day postoperative. Which task should the nurse take responsibility for completing? Removing the abdominal dressing A nurse is calculating the output of a client at the end of the shift. The nurse notes the following: client voided 400 mL at 1100 and 350 mL at 1430. The closed chest drainage system was previously marked at 155 mL and is now at 175 mL. The NG tube has 575 mL in drainage container, and 25 mL is emptied out of the Jackson-Pratt drainage tube. How many mL should the nurse record in the medical record as the client’s output? 1,370 mL A nurse is caring for a client who is postoperative following abdominal surgery. The surgeon initially prescribes a clear liquid diet. Which of the following items should the nurse include on the client’s lunch tray? Cranberry juice A nurse is caring for a client who is postoperative following vascular surgery. Which of the following signs should indicate to the nurse that the client has developed a thrombus? Dull, aching calf pain A nurse is providing discharge teaching to a client who has gastroesophageal reflux disease. Which of the following statements by the client indicates an understanding of the teaching? “I will sleep with the head of my bed elevated.” A nurse is caring for a client who has a postoperative ileus and an NG tube that has drained 2,500 mL in the past 6 hr. Which of the following electrolyte imbalances should the nurse monitor the client for? Decreased potassium level A nurse is teaching a group of middle adult clients about early detection of colorectal cancer. The nurse should include the American Cancer Society recommendation that men and women beginning at age 50 who are at average risk should have a fecal occult blood test (FOBT) and a colonoscopy at which of the following intervals? Ten years A nurse is caring for a client who is postoperative following a cholecystectomy and reports pain. Which of the following actions should the nurse take? (Select all that apply.) Offer the client a back rub. Remind the client to use incisional splinting. Identify the client’s pain level. Change the client’s position. A nurse is teaching a client about strategies to manage gastroesophageal reflux disease (GERD). Which of the following statements should the nurse include? “Lie on your right side when sleeping.” A nurse is assessing a client who is 48 hr. postoperative following abdominal surgery. Which of the following findings should the nurse report to the provider? Yellow-green drainage on the surgical incision A nurse is providing preoperative teaching for a client who will undergo surgery. The nurse explains that the client will wear antiembolism stockings during and after the procedure. When the client asks what the stockings do, which of the following responses should the nurse make? “They improve your circulation to keep blood from pooling in your legs.” A nurse is planning care for a client who is postoperative and at risk for paralytic ileus. Which of the following interventions should the nurse plan to take to promote peristalsis? Increase ambulation A nurse is caring for a client who receives intermittent enteral feedings through an NG tube. Before administering a feeding, the nurse should measure the gastric residual for which of the following purposes? To identify delayed gastric emptying A nurse is teaching a client who has stomatitis. Which of the following instructions should the nurse include? Brush teeth with a soft toothbrush A nurse is caring for client who just returned from the PACU with an IV fluid infusion and an NG tube in place following abdominal surgery. Which of the following data is the priority for the nurse to assess? The surgical dressing A nurse is assessing a client who has peritonitis. Which of the following findings should the nurse expect? Rigid abdomen A nurse is caring for a client who returns to the nursing unit from the recovery room after a sigmoid colon resection for adenocarcinoma. The client had an episode of intraoperative bleeding. Which finding indicates to the nurse that the client may be developing hypovolemic shock? Increase in the heart rate from 88 to 110/min. A nurse is providing information about pain control for a client who has acute pain following a subtotal gastric resection. Which of the following client statements indicates an understanding of pain control? “I will call for pain medication before the previous dose wears off.” A nurse is providing preoperative teaching for a client who is scheduled for a gastrectomy. Which of the following information regarding prevention of postoperative complications should the nurse include in the teaching? Instruct the client about the use of a sequential compression device A nurse is teaching a client who is preoperative for a colectomy. The client asks the nurse why he needs a large-bore NG tube. Which of the following statements should the nurse make?