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1. A community health nurse is helping to reinforce teaching about hepatitis A with a group of employees at a childcare facility. Which of the following characteristics should the nurse identify as an external factor that can impede learning for the participants?
- A. High workload
- B. Limited knowledge on the subject
- C. Poor lighting
- D. Limited space in the learning area
Correct answer: C
Rationale: The correct answer is C: 'Poor lighting.' External factors such as lighting can significantly impact the learning environment, making it difficult for participants to engage effectively. Poor lighting can strain the eyes, cause discomfort, and lead to decreased concentration. Choices A, B, and D are internal factors or issues that are not directly related to the learning environment. High workload, limited knowledge on the subject, and limited space in the learning area may affect learning differently but do not impede learning through external factors like poor lighting does.
2. A nurse is teaching dietary guidelines to a client who has celiac disease. Which of the following food choices is appropriate for the client?
- A. White flour tortillas.
- B. Potato pancakes.
- C. Wheat crackers.
- D. Canned barley soup.
Correct answer: B
Rationale: The correct answer is B, potato pancakes. Individuals with celiac disease must avoid gluten-containing foods. Potato pancakes are gluten-free, making them a suitable choice for someone with celiac disease. Choice A, white flour tortillas, contains gluten from wheat flour, making it unsuitable for a client with celiac disease. Choice C, wheat crackers, also contain gluten and should be avoided. Choice D, canned barley soup, contains barley which is a gluten-containing grain and is not appropriate for someone with celiac disease.
3. When caring for the client diagnosed with delirium, which condition is the most important for the nurse to investigate?
- A. Cancer of any type
- B. Impaired hearing
- C. Prescription drug intoxication
- D. Heart failure
Correct answer: C
Rationale: When caring for a client diagnosed with delirium, the most important condition for the nurse to investigate is prescription drug intoxication. Delirium in older adults is commonly caused by medication side effects or interactions. Investigating prescription drug intoxication is crucial as it can be a reversible cause of delirium. While cancer, impaired hearing, and heart failure are important considerations in overall care, prescription drug intoxication takes precedence in cases of delirium.
4. What should be included in dietary teaching for a client with chronic kidney disease?
- A. Increase potassium-rich foods in the diet
- B. Limit potassium and phosphorus intake
- C. Increase intake of protein-rich foods
- D. Increase fluid intake to prevent dehydration
Correct answer: B
Rationale: The correct answer is to limit potassium and phosphorus intake for a client with chronic kidney disease. Excessive potassium and phosphorus can be harmful to individuals with compromised kidney function. Option A is incorrect because increasing potassium-rich foods can exacerbate hyperkalemia in individuals with kidney disease. Option C may not be ideal as excessive protein intake can put extra strain on the kidneys. Option D is not the priority; while adequate fluid intake is important, it is not the primary focus when teaching dietary considerations for chronic kidney disease.
5. When a client with dementia frequently becomes agitated, what should the nurse prioritize investigating?
- A. Fluid and electrolyte imbalances
- B. Medication history
- C. Environmental factors
- D. Cognitive functioning
Correct answer: B
Rationale: The correct answer is to prioritize investigating the client's medication history. This is important because certain medications can contribute to agitation in clients with dementia. Understanding the medication history can help identify potential causes of agitation and guide appropriate interventions. Checking for fluid and electrolyte imbalances is important in healthcare but may not directly relate to the client's agitation. While environmental factors can influence behavior, investigating the medication history is more pertinent in this case. Cognitive functioning assessment is crucial in dementia care but may not be the priority when addressing acute agitation.
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