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Exhibits

The nurse reviews the client data. What discharge education should the nurse provide? Select all that apply.

Encourage three large meals a day.

Start with room temperature water.

Anticipate weight loss will continue even with normal diet.

Walk frequently during recovery.

Expect immediate return of ovulation.

Begin taking supplements per the healthcare provider's orders.

Advance diet from clear liquids to full liquid.

Answer and Explanation

Correct Answer : D,F,G

A. Encourage three large meals a day. This may not be appropriate for the client's current dietary plan, especially after bariatric clinic involvement and dietitian consultations.
B. Start with room temperature water. While hydration is important, this advice is too vague and does not consider the client's specific nutritional needs or restrictions.
C. Anticipate weight loss will continue even with normal diet. Weight loss should be monitored and managed carefully, especially after bariatric treatment; it should not be assumed to continue without ongoing effort and adherence to a dietary plan.
D. Walk frequently during recovery. Encourage the client to continue with regular, gentle walks as tolerated to promote circulation and weight management, which is consistent with the client's recent weight loss through walking.
E. Expect immediate return of ovulation. There is no information provided that correlates the client's medical condition with ovulation status.
F. Begin taking supplements per the healthcare provider's orders. If the healthcare provider has recommended supplements, ensure the client understands the importance of taking them as directed to support overall health.
G. Advance diet from clear liquids to full liquid. As the client recovers, it's important to gradually reintroduce different types of food, starting with clear liquids and moving to full liquids as tolerated before progressing to solid foods.
H. Dietician appointments are optional. Given the client's history with weight management and engagement with a bariatric clinic, continued dietitian support is likely crucial for sustained success.

Nursing Test Bank

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Naxlex Comprehensive Predictor Exams

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Correct Answer is D

Explanation

A. Depression: While depression may occur in some individuals with Wernicke's syndrome, confusion is the primary assessment finding associated with this condition.
B. Right lower abdominal pain: Abdominal pain is not a characteristic symptom of Wernicke's syndrome. Confusion, ophthalmoplegia, and ataxia are more common.
C. Peripheral neuropathy: While peripheral neuropathy may occur in some neurological conditions, it is not specific to Wernicke's syndrome, which primarily presents with confusion, ophthalmoplegia, and ataxia.
D. Confusion: Confusion is a hallmark symptom of Wernicke's syndrome and should be a primary focus of assessment and care planning for this condition.

A. Obtain a 12-lead electrocardiogram daily. B. Monitor and document strict intake and output. C. Assess the serum potassium level every 4 hours. D. Evaluate glucose levels before and after meals.

Correct Answer is C

Explanation

A. While monitoring the client’s cardiac status is important due to the risk of arrhythmias with hyperkalemia, obtaining a daily ECG is not the most immediate or frequent evaluation required. Continuous cardiac monitoring is typically preferred in such cases.

B. Monitor and document strict intake and output: While important for overall fluid balance, this option does not specifically address the potential cardiac complications associated with hyperkalemia and insulin administration.
C. The prescribed treatment involves insulin, which facilitates the movement of potassium into cells, thereby reducing serum potassium levels. Monitoring potassium frequently is essential to evaluate the treatment’s effectiveness and to prevent hypokalemia, which can lead to complications such as arrhythmias or muscle weakness.

D. Evaluate glucose levels before and after meals: Monitoring glucose levels is important for diabetes management but does not address the immediate cardiac risks associated with
hyperkalemia and insulin administration.

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Exhibits The nurse reviews the client data. What discharge education should the nurse provide? Select all that apply.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client is admitted with the diagnosis of Wernicke's syndrome. Which assessment finding should the nurse use in planning the client's care?

Correct Answer is D

Explanation

The healthcare provider prescribes a 5% dextrose injection with 20 units of regular insulin for a client with a serum potassium level of 6.0 mEq/L (6.0 mmol/L) and glucose level of 180 mg/dL (10.0 mmol/L). Which evaluation is most important for the nurse to include in this client's plan of care?

Correct Answer is C

Explanation

On admission to the emergency department, a client who was diagnosed with bipolar disorder 3 years ago reports taking a handful of medications this morning and left a suicide note for family. Which information is most important for the nurse to obtain?

A client who recently received a prescription for ramelteon to treat sleep deprivation reports experiencing several side effects since taking the drug. Which side effect should the nurse report to the healthcare provider?

The nurse is developing a plan of care for a client who reports chest pain on exertion and who is newly diagnosed with cardiovascular disease. Which outcome should the nurse include in the plan of care for this client?

A client arrives for an annual physical exam and reports having calf pain. The client's health history reveals peripheral arterial disease. Which question should the nurse ask the client about expected findings related to chronic arterial symptoms?

An older adult client is being admitted to a short-term rehabilitation facility after a long hospitalization. The nurse is performing a functional assessment with the client. Which action should the nurse implement?

The nurse is setting up the equipment to assist with a sigmoidoscopy while the practical nurse (PN) positions the client in a flat prone position. Which action should the nurse implement?

A 22-year-old client is admitted to the hospital in diabetic ketoacidosis (DKA. The client's parent is insisting to know the laboratory test results. Which is the best response for the nurse to provide?

Exhibits

The nurse reviews the client data. What discharge education should the nurse provide? Select all that apply.