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The nurse reviews teaching with a client with cancer of the larynx who is scheduled for a total laryngectomy and radical neck dissection. The nurse concludes that the teaching is effective when the client states, "After surgery, I will still be able to:

Chew and swallow foodThere is still a pathway from the mouth to the stomach; eating patterns are not lost when a laryngectomy is performed

infant with non organic failure to thrive

Following a structured routine throughout the day

A 9-year-old child who has successfully completed the emergency (resuscitative) phase of treatment for a severe burn injury is started on a high-protein, high-calorie diet. Which snacks should the nurse encourage between meals? Select all that apply. 1 Crackers and cheese 2 White bread and honey 3 Orange juice and cookies 4Banana pudding and whipped cream 5 Frozen yogurt and chocolate sprinkles

The cheese increases protein intake, which is needed for tissue repair, and the crackers contain carbohydrates that provide calories for the increased metabolism. The milk in the pudding contains protein, and whipped cream contains fat. The banana is high in potassium. All of these nutrients are essential for tissue repair. Frozen yogurt contains both protein and calories. Although bread and honey increase caloric intake, they furnish little of the protein needed for tissue repair. Although orange juice and cookies increase vitamin and fluid intake, they do not supply protein.

What should the nurse instruct the client to do to limit triggering the pain associated with trigeminal neuralgia? 1 Drink iced liquids. 2 Avoid oral hygiene. 3 Apply warm compresses. 4 Chew on the unaffected side.

The client may avoid stimulating the involved trigeminal nerve and thus prevent pain by chewing on the unaffected side. Food and fluids that are too hot or too cold can precipitate pain. Although oral hygiene may initiate pain, it cannot be avoided. It can be modified to include rinsing the mouth or using a soft swab instead of a toothbrush. Warm compresses may precipitate pain.

Which nursing interventions are appropriate while caring for a preschooler exposed to lead poisoning? Select all that apply. 1 Administering the local anesthetic procaine 2 Educating parents to use hot water for cooking 3 Preventing further exposure of the child to lead 4 Identifying the sources of lead in the environment 5 Administering chelating agents into a small muscle mass

While caring for a preschooler exposed to lead poisoning, the nurse should administer the local anesthetic procaine, prevent further exposure of the child to lead, and identify the sources of lead in the environment. In an attempt to identify the source of the lead, the nurse should educate parents to use cold water, instead of hot water, while cooking. The nurse should administer chelating agents into a large muscle mass.

A public health nurse is conducting an initial visit to an older depressed client who lives alone and performs all tasks of daily living. What is the nurse's most significant intervention at this time? Supporting the client's usual routine Assisting the client in setting new goals Assisting the client in focusing on the future Arranging for the client to have help in the home

A routine is important to older adults, because it promotes a sense of control and security. Assisting the client in setting new goals is an important strategy for future planning, but it is not the primary goal for the client at this time. Older people may need to focus on the past as much as they do on the future; a life review is often conducted during this stage of development. Arranging for the client to have help in the home may be helpful but may not be welcomed by the client.

What are the primary nursing interventions to check the circulation in a client? Select all that apply. 1 The nurse should prepare for chest decompression. 2 The nurse should evaluate the level of consciousness. 3 The nurse should prepare for endotracheal intubation. 4 The nurse should monitor the vital signs, especially the pulse. 5 The nurse should maintain vascular access with a large-bore catheter

As a primary nursing intervention for circulation, the nurse should check the vital signs of the client, especially the pulse and blood pressure of the client. The nurse should maintain vascular access with a large bore catheter during an intervention involving the circulation. The nurse should prepare for chest decompression if required with a tension pneumothorax, because this could lead to cardiovascular collapse. Evaluation for level of consciousness is a nursing intervention to assess disability. The nurse should prepare for endotracheal intubation as a nursing intervention for cervical spine and airway.

A client with myasthenia gravis, who is living in a nursing home, experiences inadequate symptomatic control with pyridostigmine bromide, and long-term steroid therapy has been initiated. What is especially important for the nurse to ensure? 1The client increases sodium intake. 2Protective isolation is established. 3Total daily fluid intake is decreased. 4The client is monitored for an exacerbation of symptoms.

Exacerbation of myasthenia gravis may occur temporarily at the beginning of steroid therapy, causing respiratory embarrassment and dysphagia. Increasing sodium intake is contraindicated because steroids increase sodium retention. Although clients should avoid contact with persons who have upper respiratory infections, protective isolation (neutropenic precautions) is not required. Decreasing total daily fluid intake is unnecessary; adequate fluid intake should be maintained.

What should the nurse do to prevent deformities of the knee in a client with an exacerbation of arthritis? Select all that apply. 1 Encourage motion of the joint. 2 Maintain a knee brace on the leg. 3 Keep the client on a regimen of bed rest. 4 Maintain joints in functional alignment when resting. 5 Immobilize the joint with pillows until pain subsides.

Exercise of involved joints is important to maintain optimal mobility and prevent buildup of calcium deposits. Functional alignment places the least strain on joints, muscles, and tendons. Immobilization causes loss of joint mobility and contractures. Immobility promotes the development of contractures. Immobilization with pillows promotes the development of contractures.

What nutrients is needed for red blood cell synthesis?

Vit c and protein

A nurse is providing counseling to a client with the diagnosis of systemic lupus erythematosus (SLE). Which recommendations are essential for the nurse to include? Select all that apply.

"Wear a large-brimmed hat." "Take your temperature daily." "Balance periods of rest and activity." A fever is the major sign of an exacerbation. A balance of rest and activity conserves energy and limits fatigue. Malaise, fatigue, and joint pain are associated with SLE. SLE can cause alopecia, and hair care recommendations include the use of mild protein shampoos and avoidance of harsh treatments, like permanents or highlights, and use of large-brimmed hat for skin protection. Mild, not strong, soap and other skin products should be used on the skin. The skin should be washed, rinsed, and dried well and lotion should be applied. Exposing the skin to the sun as often as possible is not recommended. Exposure to ultraviolet light may damage the skin and aggravate the photosensitivity associated with SLE.

A nurse is discussing diet with a pregnant client who is 5 feet 4 inches tall (163 cm) and whose pre-pregnancy weight was 120 lb (54 kg). What should the nurse include about the changes in calories and nutrients, compared with the pre-pregnancy diet, during the second trimester? 1 Decreasing daily fat consumption by 220 calories 2 Increasing total daily caloric intake by 340 calories 3 Increasing total daily caloric intake by 460 calories 4 Decreasing daily carbohydrate consumption by 130 calories

2 Increasing total daily caloric intake by 340 calories

A client who had a myocardial infarction is in the coronary care unit on a cardiac monitor. The nurse observes runs of ventricular tachycardia on the screen. What medication should the nurse prepare to administer? 1 Digoxin 2 Furosemide 3 Amiodarone 4 Norepinephrine

3 Amiodarone Amiodarone decreases the irritability of the ventricles by prolonging the duration of the action potential and refractory period. It is used in the treatment of ventricular dysrhythmias such as ventricular tachycardia. Digoxin slows and strengthens ventricular contractions; it will not rapidly correct ectopic beats. Furosemide, a diuretic, does not affect ectopic foci. Norepinephrine is a sympathomimetic and is not the drug of choice for ventricular irritability.

The nurse is caring for a client with a 30% total body surface area burn. Which assessment finding indicates to the nurse that the client's fluid replacement is adequate? 1 Increasing hematocrit level 2 Urinary output of 15 to 20 mL/hr 3 Slowing of a previously rapid pulse rate 4 Central venous pressure progressing from 5 to 1 mm Hg

3 Slowing of a previously rapid pulse rate The pulse rate is one indicator of optimum vascular fluid volume; the pulse rate decreases as intravascular volume normalizes. Increasing hematocrit level indicates hemoconcentration resulting from hypovolemia. Urinary output of 0.5 to 1 mL/kg/hr indicates inadequate kidney perfusion; if adequate, output should be greater than 30 mL/hr. Central venous pressure decreasing from 5 to 1 mm Hg indicates hypovolemia.

A nurse is creating a plan of care for range-of-motion exercises for a client with rheumatoid arthritis who has severe pain and swelling of the joints in both hands. What should the plan include? 1 Passively performing the exercises for the client 2 Avoiding the exercises if the client reports discomfort 3Applying heat or cold before the exercises 4 Gradually increasing the exercises to improve mobility and independence

3Applying heat or cold before the exercises Heat and cold applications reduce inflammation and discomfort. Passively performed exercises by the nurse will depend on the client's tolerance. Avoiding exercise will increase the destructive effects of immobility. Exercises are necessary to prevent contractures and permanent joint damage, but cannot be increased gradually unless the client is able to tolerate them.

A 20-year-old woman visiting the clinic says that she wishes to begin using depot medroxyprogesterone acetate as a form of birth control. What important information should the nurse include when teaching the client about this drug? 1 "Medroxyprogesterone offers protection against the herpes simplex virus." 2 "You will need a repeat injection every 6 months." 3 "Increase your intake of iron-rich foods to prevent anemia from increased blood loss during menstruation." 4 "Increase your calcium intake and exercise because loss of bone mineral density may occur."

4 "Increase your calcium intake and exercise because loss of bone mineral density may occur." Loss of bone mineral density is a significant side effect of depot medroxyprogesterone acetate, and increased calcium intake and exercise should be encouraged. Medroxyprogesterone should be administered every 11 to 13 weeks; 6 months is too long before the next dose. Menstrual periods usually lighten or disappear over time. Medroxyprogesterone confers no protection against herpes simplex virus.