Extract:

Question 1 of 5

The nurse is counseling a client about the prevention of coronary heart disease. Which of the following vitamins should the nurse recommend the client include in his diet to reduce homocysteine levels? Select all that apply.

Correct Answer: B, C, D

Rationale: Vitamin B6, folate, and vitamin B12 reduce homocysteine levels, a risk factor for coronary heart disease.

Question 2 of 5

A hospitalized client fell on the floor and sustained a small laceration on her hand that required stitches. The intern will suture the client's hand at the client's bedside and asks for bupivacaine (Marcaine) with epinephrine and a suture kit in order to suture the laceration. The nurse should question which of the following?

A. The intern's ability to suture. B. The client's room as an aseptic environment. C. Marcaine with epinephrine as the local anesthetic. D. The cosmetic effect from not having a plastic surgeon do the suturing.

Correct Answer: C

Rationale: Bupivacaine with epinephrine should be questioned for hand lacerations, as epinephrine can cause vasoconstriction and potential tissue ischemia in extremities.

Question 3 of 5

A client with a history of osteoporosis is prescribed alendronate (Fosamax). The nurse should instruct the client to:

A. Take it with meals B. Remain upright for 30 minutes after taking C. Take it at bedtime D. Crush the tablet for easier swallowing

Correct Answer: B

Rationale: Remaining upright for 30 minutes after taking alendronate prevents esophageal irritation and enhances absorption.

Question 4 of 5

Which of the following is appropriate when developing a plan of care for promoting the development of a preschooler? Select all that apply.

A. Providing anticipatory guidance for parents. B. Helping the parents understand their child's behavior. C. Identifying deviations from normal growth and development patterns. D. Determining the child's future development. E. Sending the child to a day care center.

Correct Answer: A,B,C

Rationale: Anticipatory guidance, understanding behavior, and identifying deviations support preschooler development. Predicting future development is not feasible, and daycare is not universally required.

Question 5 of 5

A client has nephrotic syndrome. To aid in the resolution of the client's edema, the physician orders 25% albumin. In addition to an absence of edema, the nurse should evaluate the client for which expected outcome?

A. Crackles in the lung bases. B. Blood pressure elevation. C. Cerebral edema. D. Cool skin temperature in lower extremities.

Correct Answer: B

Rationale: Albumin increases oncotic pressure, pulling fluid into the vascular space, which may elevate blood pressure. Crackles, cerebral edema, or cool extremities would indicate complications.