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1. A client who is to undergo a colonoscopy is being taught by a nurse about the procedure. Which of the following statements by the client indicates an understanding of the teaching?
- A. I will drink liquids right up until the procedure.
- B. I will need to stop eating and drinking at least 24 hours before the procedure.
- C. I will be sedated and will not feel any pain during the procedure.
- D. I will not need to follow any specific dietary restrictions for this procedure.
Correct answer: C
Rationale: Choice C is the correct answer. During a colonoscopy, clients are typically sedated, so they do not feel any pain during the procedure. Choices A, B, and D are incorrect. Clients are usually required to stop eating and drinking at least 24 hours before a colonoscopy, and there are specific dietary restrictions that need to be followed before the procedure to ensure a successful examination.
2. A client at 20 weeks of gestation is being taught by a nurse about an alpha-fetoprotein (AFP) test. Which of the following information should the nurse include?
- A. This test is used to confirm pregnancy
- B. This test is used to detect neural tube defects
- C. This test will determine the baby's lung maturity
- D. This test will check for gestational diabetes
Correct answer: B
Rationale: The correct answer is B: 'This test is used to detect neural tube defects.' An alpha-fetoprotein test is essential for screening neural tube defects in the fetus, not for confirming pregnancy, determining lung maturity, or checking for gestational diabetes. Detecting neural tube defects is crucial for early intervention and management of potential health issues in the baby.
3. A client who is taking furosemide is being taught by a nurse about dietary modifications. Which of the following foods should the nurse recommend to the client?
- A. Bananas
- B. Cabbage
- C. Potatoes
- D. Carrots
Correct answer: A
Rationale: The correct answer is A, Bananas. Bananas are high in potassium, which is essential for clients taking furosemide to prevent hypokalemia. Furosemide is a diuretic that can cause potassium loss through increased urine output. Therefore, recommending foods rich in potassium, such as bananas, can help maintain potassium levels within the normal range. Choices B, C, and D are not the best recommendations in this case as they are not particularly high in potassium.
4. A nurse in a long-term care facility is assisting with an in-service for newly hired assistive personnel about legal issues within the facility. Which of the following should the nurse include as an example of assault?
- A. Threatening to withhold food from a client
- B. Informing a client about an upcoming procedure
- C. Informing a client about risks of refusing treatment
- D. Informing a client that they will be given an injection against their will
Correct answer: D
Rationale: The correct answer is D because assault involves threatening a client with harm or unwanted procedures. In this scenario, informing a client that they will be given an injection against their will constitutes assault. Choices A, B, and C do not involve the element of threatening harm or unwanted procedures, making them incorrect. Choice A is more related to neglect, choice B is related to informing the client about a procedure, and choice C is related to informed consent and refusal of treatment, not assault.
5. A nurse is reinforcing teaching with a client about the client's recent diagnosis of multiple sclerosis. The client states, 'I am very upset and I want to be alone for a little while.' Which of the following responses should the nurse make?
- A. I see that you are feeling overwhelmed. I will come back when you are ready
- B. This is normal, and I will check on you later
- C. You are feeling frustrated. Let's talk about your concerns.
- D. You will feel better soon. Let me get you some water.
Correct answer: A
Rationale: Acknowledging the client's feelings and allowing them space demonstrates understanding and respect for their emotions.
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