A nurse assists a male client with Parkinson's disease (PD) to ambulate in the hallway. The client appears to 'freeze' and then carefully lifts one leg and steps forward. He tells the nurse that he is pretending to step over a crack on the floor. How should the nurse respond?

Correct Answer: B

Rationale: In this scenario, option B is the correct response. The client with Parkinson's disease is exhibiting a phenomenon known as "freezing of gait," a common symptom in PD where individuals feel as though their feet are glued to the floor and have difficulty initiating movement. By pretending to step over a crack, the client is using a technique called "cued stepping," which can help overcome freezing episodes and facilitate ambulation. Option A is incorrect as re-orienting the client is not addressing the immediate issue of freezing of gait. Option C is also incorrect as simply changing the surface to carpeted area may not address the underlying problem and may not be practical in all settings. Option D is incorrect as assessing cognition is not the priority at this moment when the client is experiencing a physical symptom related to PD. Educationally, it is important for nurses to understand the various manifestations of Parkinson's disease, including freezing of gait, and how to effectively manage these symptoms to support the client in their activities of daily living. Understanding and recognizing cues like pretending to step over a crack can be crucial in providing holistic care for clients with PD.

Correct Answer: A

Rationale: In this scenario, the correct intervention is to patch one eye and then the other every few hours (Option A). This intervention is based on the concept of occlusion therapy, which helps alleviate double vision (diplopia) by blocking the vision from one eye, allowing the brain to focus on the vision from the other eye, thus reducing the perception of double images. Option B, encouraging bedrest until diplopia resolves, is incorrect because bedrest does not address the underlying cause of diplopia and may not be effective in treating this symptom related to multiple sclerosis. Option C, limiting intake of oral fluids, is also incorrect as it is not a relevant intervention for diplopia. Hydration is important, especially in the case of urinary tract infection, but it does not directly address the double vision. Option D, administering artificial tear drops to both eyes, is not the most appropriate intervention for diplopia associated with multiple sclerosis. Artificial tear drops are typically used to relieve dry eyes and do not directly address the visual symptom of double vision. Educationally, understanding the rationale behind the intervention of patching one eye and rotating to the other can help nursing students comprehend the management of diplopia in patients with multiple sclerosis. It reinforces the concept of occlusion therapy and its application in clinical practice to improve patient outcomes.

Correct Answer: C

Rationale: The correct answer is C) Wear braces on both wrists during the night. This teaching is appropriate for a client with bilateral carpal tunnel syndrome experiencing worsened pain and tingling at night. Wrist braces help to keep the wrists in a neutral position, reducing pressure on the median nerve and alleviating symptoms during sleep. This can improve comfort and promote better rest. Option A) Elevating the hands on two pillows at night may provide some relief by reducing swelling, but it does not address the underlying issue of wrist positioning that wrist braces can offer. Option B) Notifying the healthcare provider is important for any significant changes in symptoms or condition, but it does not address the immediate need for symptom management. Option D) Applying cold compresses before bedtime may help with pain relief by numbing the area, but it does not address the mechanical issue of wrist positioning that braces can provide. In an educational context, it's important for nurses to understand the rationale behind interventions for specific conditions like carpal tunnel syndrome in order to provide effective client education. By explaining the benefits of wearing wrist braces to keep the wrists in a neutral position during sleep, nurses can empower clients to manage their symptoms effectively and improve their quality of life.

Correct Answer: D

Rationale: In this scenario, the correct answer is D) Auscultate bowel sounds. Following a nephrectomy, abdominal pressure and nausea could indicate a paralytic ileus or bowel obstruction, which are potential postoperative complications. Auscultating bowel sounds is essential to assess for the presence or absence of bowel motility and potential blockages. Option A) Palpating the abdomen may exacerbate any potential complications, such as causing discomfort or rupturing a sensitive area post-surgery. It is not the best initial assessment for this situation. Option B) Measuring hourly urine output is important in monitoring kidney function post-nephrectomy but is not directly related to the presenting symptoms of abdominal pressure and nausea. Option C) Ambulating the client in the hallway may be beneficial for general postoperative recovery but is not the priority in this situation where abdominal symptoms need immediate assessment. Educationally, this question highlights the importance of recognizing potential postoperative complications in patients who have undergone nephrectomy. It emphasizes the need for thorough assessment skills and prioritizing assessments based on the client's symptoms to provide timely and appropriate care.

Correct Answer: B

Rationale: In this scenario, the correct answer is option B) Beef steak with steamed broccoli and orange slices. The client's presentation of chronic fatigue, low hemoglobin, and microcytic, hypochromic RBCs suggests iron deficiency anemia. Beef is a good source of heme iron, which is more readily absorbed by the body compared to non-heme iron found in plant-based foods. Broccoli and orange slices are rich in Vitamin C, which enhances iron absorption. Option A) Cheese pasta and a lettuce and tomato salad lacks significant iron content needed to address the anemia. Option C) Broiled white fish with a baked sweet potato is a healthy meal choice but does not provide sufficient iron. Option D) Grilled shrimp and seasoned rice with asparagus salad also lacks iron-rich foods necessary for addressing the anemia. Educationally, understanding the importance of dietary choices in managing pediatric cardiovascular disorders like anemia is crucial for nursing practice. Teaching patients about iron-rich foods and how to enhance iron absorption through dietary combinations can significantly impact their health outcomes. Nurses play a vital role in educating patients on nutrition to support their treatment and recovery.