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Questions 148

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Question 1 of 5

The nurse is caring for a client hospitalized with bipolar disorder, manic phase who is taking lithium. Which of the following snacks would be best for the client with mania?

Correct Answer: C

Rationale: An apple is a healthy, low-sodium snack, suitable for a client on lithium, as high sodium foods like potato chips can affect lithium levels.

Question 2 of 5

Prior to drawing blood for blood gas analysis, the nurse conducts the modified Allen test to ensure there is adequate collateral circulation. The nurse asks the client to extend the wrist over a rolled towel and make a fist. Place the following steps (Roman numerals) in order from first to last.

Order the Items

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Ask the client to open and close the hand until the skin blanches.
Palpate the ulnar and radial pulses and apply pressure to both arteries.
Observe the hand for color.
Release the ulnar artery while maintaining pressure on the radial artery.

Correct Answer: A,B,D,C

Rationale: Modified Allen test sequence: Blanch hand (I), compress arteries (II), release ulnar artery (IV), observe color return (III) to confirm collateral circulation.

Question 3 of 5

The nurse is caring for a client who is postoperative day 3 following a bowel resection. The client reports sudden, severe abdominal pain and distention. Which of the following actions should the nurse take FIRST?

Correct Answer: B

Rationale: sudden, severe abdominal pain and distention may indicate a complication such as an anastomotic leak, requiring immediate physician notification

Question 4 of 5

The nurse is caring for a client hospitalized with bipolar disorder, manic phase who is taking lithium. Which of the following snacks would be best for the client with mania?

Correct Answer: C

Rationale: An apple is a healthy, low-sodium snack, suitable for a client on lithium, as high sodium foods like potato chips can affect lithium levels.

Question 5 of 5

Which assignment should not be performed by the nursing assistant?

Correct Answer: D

Rationale: Administering an enema is an invasive procedure requiring clinical judgment, which is beyond the scope of a nursing assistant's responsibilities.

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