A nurse in an outpatient clinic is caring for a client
Vital Signs
BP 124/68 mm Hg
Heart rate 80/min
Temperature 37° C (98.6° F) Respiratory rate 16/min Weight 67.1 kg (148 lb)
Which of the following statements should the nurse include in the client's teaching? Select all that apply.
Try using an abdominal support belt
Take hot showers to help relieve itching"
"Wear loose-fitting clothing"
"Wear flat or low-heeled shoes"
"You can douche twice weekly."
"Eat two large meals a day."
You should avoid fried foods"
Correct Answer : C,D,G
Choice A reason:
"Try using an abdominal support belt". This statement is incorrect. There is no indication or relevance for using an abdominal support belt based on the vital signs and weight provided. This statement is not appropriate for the client's teaching.
Choice B reason:
"Take hot showers to help relieve itching" This statement is incorrect. Itching is not mentioned in the vital signs and weight provided. Additionally, taking hot showers might not be relevant to the client's condition or needs. This statement is not appropriate for the client's teaching.
Choice C reason:
"Wear loose-fitting clothing" This is an appropriate statement for the client's teaching. Wearing loose-fitting clothing can provide comfort and allow better circulation, which might be helpful for some clients.
Choice D reason:
"Wear flat or low-heeled shoes" This is an appropriate statement for the client's teaching. Wearing flat or low-heeled shoes can help provide comfort and support, especially if the client has any foot or back issues.
Choice E reason:
"You can douche twice weekly." Douche is not relevant to the vital signs and weight provided, and it is generally not recommended for routine use as it can disrupt the natural balance of vaginal flora. This statement is not appropriate for the client's teaching.
Choice F reason:
"Eat two large meals a day." This statement does not align with a healthy eating pattern, and it might not be appropriate for the client's health needs. The recommendation for a balanced diet usually includes several smaller meals throughout the day. This statement is not appropriate for the client's teaching.
Choice G reason:
"You should avoid fried foods." This is an appropriate statement for the client's teaching. Avoiding fried foods can be beneficial for overall health, especially if the client is trying to manage weight or maintain a balanced diet.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Incorrect. Encouraging a focus on tertiary health interventions might not address the preventive health needs of the population.
B. Incorrect. While raising awareness about industrial pollution is important, it might not be the primary focus of a public health program in a rural area.
C. Incorrect. Utilizing a nurse from outside the community might not be the most effective approach for understanding the specific health needs and context of the local population.
D. Correct. Providing anticipatory guidance classes to parents through public schools is a community-based preventive approach that can address the health needs of families and children in the area.
Correct Answer is {"dropdown-group-1":"D","dropdown-group-2":"B"}
Explanation
A. Hypoglycemia might be a concern if the baby had risk factors like maternal diabetes, but this information is not provided.
B. Tachycardia is not mentioned as a concern in the scenario, and the heart rate is within normal limits for a newborn
C. Bronchopulmonary Dysplasia (BPD): The newborn's respiratory rate is increasing over time, along with the presence of grunting and retractions. These are signs of respiratory distress. Bronchopulmonary dysplasia (BPD) is a chronic lung disease that primarily affects premature infants who require mechanical ventilation and oxygen therapy for an extended period. The symptoms align with the respiratory distress and could suggest a risk for BPD.
D. Transient Tachypnea of the Newborn (TTN): The newborn's respiratory rate is increasing over time, along with grunting and retractions. These signs are consistent with transient tachypnea of the newborn, which is a self-limiting condition characterized by rapid breathing shortly after birth. It is more common in infants born via cesarean delivery and may result from delayed clearance of lung fluid.
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