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Question 1 of 5.

Discharge teaching for the client who has a total gastrectomy should include which of the following?

A. Need for the client to increase fluid intake to 3000 mL/day

B. Follow-up visits every 3 weeks for the first 6 months

C. B12 injections needed for the rest of the client's life

D. Need to eat three full meals with plenty of fiber per day

Explanation: There will be no need to increase fluid intake excessively, because dumping syndrome could present a problem. Follow-up visits every 3 weeks are not a standard recommendation. Follow-up visits will be highly individualized. With removal of the stomach, intrinsic factor will no longer be produced. Intrinsic factor is necessary for vitamin B12 absorption. Parenteral injections of B12 will be needed on a monthly basis for the rest of the person's life. Smaller, more frequent meals, rather than large, bulky meals, are recommended to prevent problems with dumping syndrome.

Question 2 of 5.

A healthcare worker is referred to the nursing office with a suspected latex allergy. The first symptom of latex allergy is usually:

A. Oral itching after eating bananas

B. Swelling of the eyes and mouth

C. Difficulty in breathing

D. Swelling and itching of the hands

Explanation: Latex allergy often first presents as localized skin reactions, such as swelling and itching of the hands, due to direct contact with latex products.

Question 3 of 5.

During the change of shift report, a nurse writes in her notes that she suspects illegal drug use by a client assigned to her care. During the shift, the notes are found by the client's daughter. The nurse could be sued for:

A. Libel

B. Slander

C. Malpractice

D. Negligence

Explanation: Libel involves written defamatory statements, such as unverified suspicions of drug use in notes accessible to others, potentially harming the client's reputation.

Question 4 of 5.

A client with myasthenia gravis is admitted in a cholinergic crisis. Signs of of cholinergic crisis include:

A. Decreased blood pressure and constricted pupils

B. Increased heart rate and increased respirations

C. Increased respirations and increased blood pressure

D. Anoxia and absence of the cough reflex

Explanation: Cholinergic crisis, often from excessive anticholinesterase medication, causes parasympathetic overstimulation, leading to decreased blood pressure and constricted pupils.

Question 5 of 5.

During morning assessments, the nurse finds that a client's nephrostomy tube has been clamped. The nurse's first action should be to:

A. Assess the drainage bag.

B. Check for bladder distention.

C. Unclamp the tubing.

D. Irrigate the tubing.

Explanation: Unclamping the nephrostomy tube is the priority to restore urine flow and prevent complications like hydronephrosis or infection.

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