which of the following statements indicates adequate dietary understanding in a client with constipation

NCLEX-PN

Safe and Effective Care Environment Nclex PN Questions

1. Which of the following statements indicates adequate dietary understanding in a client with constipation?

A. “I should decrease my intake of fluids.”
B. “I should decrease my level of activity.”
C. “I should increase my intake of apples.”
D. “I should increase my intake of milk.”

Correct answer: “I should increase my intake of apples.”

Rationale: The correct answer is, “I should increase my intake of apples.” This statement indicates adequate dietary understanding in a client with constipation because apples are a good source of fiber, which helps alleviate constipation. Adequate fiber intake is essential for promoting bowel regularity. Choices A and B are incorrect as decreasing fluids and activity level can worsen constipation. Insufficient fluid intake can lead to hard stools, exacerbating constipation. Decreasing activity can also slow down bowel movements. Choice D is incorrect because milk is not a high-fiber food and may not effectively address constipation. While milk can have a mild laxative effect on some individuals, it is not a primary solution for constipation, especially when compared to high-fiber foods like apples.

2. When a client's postoperative pain seems to be getting worse due to grief over the recent death of their spouse, what should the nurse consider?

A. calling the physician for an increased dosage of pain medication
B. calling the physician for a sedative
C. referring the client for a psychiatric consult
D. developing interventions for grief and loss

Correct answer: developing interventions for grief and loss

Rationale: The correct answer is developing interventions for grief and loss. In this scenario, the client's pain is not solely sensory but also affective due to grieving over the death of their spouse. It is essential to address the emotional component of pain by providing support and interventions for grief and loss. Referring the client for a psychiatric consult may not be necessary as grieving is a normal response to such a significant loss. Calling the physician for an increased dosage of pain medication or a sedative solely focuses on the sensory aspect of pain and does not address the underlying emotional distress.

3. The nurse is teaching a client about erythema infectiosum. Which of the following factors is not correct?

A. There is no rash.
B. The disorder is uncommon in adults.
C. There is no fever.
D. There is sometimes a 'slapped face' appearance.

Correct answer: The disorder is uncommon in adults.

Rationale: The correct answer is that the disorder is uncommon in adults. Erythema infectiosum, also known as Fifth's disease, commonly affects children and is characterized by a 'slapped face' appearance. It is associated with a rash and sometimes a low-grade fever. Therefore, the statement 'The disorder is uncommon in adults' is not correct, making it the correct answer. The other statements about the presence of a rash, 'slapped face' appearance, and the possibility of a fever are accurate in the context of erythema infectiosum.

4. Which of these clients should the LPN/LVN see first?

A. a client with a newly placed NG tube who is complaining of pain around the face and a plugged nose
B. a post-op prostatectomy client who complains of bladder spasms and blood in his foley bag
C. a client in an arm cast who is 2 days post-op and reports feelings of numbness and tingling in her affected arm
D. a client newly diagnosed with Hepatitis A who reports stomach pain and itchy skin

Correct answer: a client in an arm cast who is 2 days post-op and reports feelings of numbness and tingling in her affected arm

Rationale: Numbness and tingling hours or days after a cast is applied may indicate compartment syndrome and should be reported to a medical provider right away. This is a potential emergency situation that requires immediate attention to prevent complications. The other options present expected or typical symptoms related to their diagnosis, which do not require immediate intervention. Complaints related to a newly placed NG tube such as pain around the face and a plugged nose may require assessment and intervention but are not as urgent as potential compartment syndrome. Bladder spasms and blood in the foley bag post-prostatectomy are common postoperative issues that can be addressed after the client in the arm cast with potential compartment syndrome is seen. Stomach pain and itchy skin in a client with Hepatitis A are common symptoms of the condition and do not indicate an emergency situation.

5. A nurse monitoring a client with a chest tube notes that there is no tidaling of fluid in the water seal chamber. After further assessment, the nurse suspects that the client’s lung has reexpanded and notifies the healthcare provider. The healthcare provider verifies with the use of a chest x-ray that the lung has reexpanded, then calls the nurse to ask that the chest tube be removed. Which action should the nurse take first?

A. Explain the procedure to the client, then remove the chest tube.
B. Call the nursing supervisor.
C. Inform the healthcare provider that removal of a chest tube is not a nursing procedure.
D. Obtain petrolatum-impregnated gauze and ask another nurse to assist in removing the chest tube.

Correct answer: Inform the healthcare provider that removal of a chest tube is not a nursing procedure.

Rationale: The correct action for the nurse to take first is to inform the healthcare provider that removal of a chest tube is not a nursing procedure. Actual removal of a chest tube is the duty of a healthcare provider. If the healthcare provider insists that the nurse remove the tube, the nurse must contact the nursing supervisor. Some agencies’ policies and procedures may permit an advanced practice nurse to remove a chest tube, but there is no information in the question to indicate that the nurse is an advanced practice nurse. Choice A is incorrect because the nurse should not proceed with removing the chest tube without proper authorization. Choice B is incorrect as calling the nursing supervisor should come after clarifying with the healthcare provider. Choice D is incorrect as the nurse should not begin the process of removing the chest tube without proper guidance and authorization.