Extract:

Question 1 of 5

A client with a history of atrial fibrillation is prescribed warfarin (Coumadin). The nurse should teach the client to avoid which of the following foods?

Correct Answer: A

Rationale: Green leafy vegetables are high in vitamin K, which can reduce warfarin's anticoagulant effect.

Question 2 of 5

A client has polycystic kidney disease. The client asks the nurse, 'How did I get these fluid-filled bubbles on my kidneys? I have not had any X-ray type tests.' How should the nurse respond to help the client understand risk factors for this disease process?

A. Second-hand smoke puts you at greater risk for developing cysts.' B. Exposure to dyes used to color fruits and vegetables increases the risk of polycystic kidney disease.' C. There is a higher incidence of polycystic kidney disease among blood relatives.' D. Drinking alcohol daily allows the kidneys to develop cysts.'

Correct Answer: C

Rationale: Polycystic kidney disease is primarily genetic, with a higher incidence among blood relatives due to autosomal dominant or recessive inheritance patterns.

Question 3 of 5

A client has undergone a vasectomy. The nurse instructs the client that he can begin having unprotected intercourse:

A. When desired because sterilization is immediate. B. As soon as scrotal edema and tenderness resolve. C. When the sperm count reflects sterilization. D. After 6 to 10 ejaculations.

Correct Answer: C

Rationale: A vasectomy requires confirmation of azoospermia (no sperm in semen) via sperm count before unprotected intercourse to ensure sterilization, as sperm may remain in the reproductive tract initially.

Question 4 of 5

The nurse performs an assessment on a client with cancer and notes that the client is receiving pain medication via this type of catheter. (Refer to the figure.) What should the nurse document that the client has?

A. Epidural catheter B. Hickman catheter C. Central venous catheter (CVC) D. Patient-controlled analgesia (PCA) pump

Correct Answer: A

Rationale: An epidural catheter is placed in the epidural space. The epidural space lies between the dura mater and the vertebral column. When an opioid is injected into the epidural space, it binds to opiate receptors located on the dorsal horn of the spinal cord and blocks the transmission of pain impulses to the cerebral cortex of the brain. Because the opioid does not cross the blood-brain barrier, pain relief results from drug levels in the spinal cord rather than in the plasma, with little central or systemic distribution of the medication. A Hickman catheter is a vascular access device that is surgically inserted, tunneled through the subcutaneous tissue, and is used to manage long-term intravenous therapy. A CVC is inserted into a large vein (typically the internal or external jugular or the superior vena cava) that leads to the right atrium of the heart. A PCA pump is the device that allows the client to self-administer pain medication.

Question 5 of 5

You are caring for a client who has been assessed as having a past history of violent and dangerous behaviors towards others. You, as the nurse, are concerned about this client's past history and the dangers that may adversely affect others including staff, visitors and other clients on the unit. What is the first thing that you should do to prevent violence towards others?

A. Restrain the client B. Place the client in seclusion C. Get an order for a sedating medication D. Establish trust with the client.

Correct Answer: D

Rationale: Establishing trust is the first step in de-escalating potential violence, as it fosters a therapeutic relationship and reduces the client's anxiety or agitation, which could otherwise escalate into violent behavior.