The nurse is preparing a discharge teaching plan for a client who had a liver transplant. Which instruction is most important to include in this plan?

Limit intake of fatty foods for one month after surgery.

Avoid crowds for first two months after surgery.

Notify the healthcare provider if edema occurs.

Increase activity and exercise gradually, as tolerated.

Answer and Explanation

The Correct Answer is B

Rationale:

A. Limit intake of fatty foods for one month after surgery: While dietary modifications are beneficial for overall liver health, avoiding fatty foods is not the top priority post-transplant. The client’s greatest risk in the early period is infection due to immunosuppressive therapy.

B. Avoid crowds for first two months after surgery: Immunosuppressive medications increase the client’s susceptibility to infections. Avoiding crowds reduces exposure to viruses and bacteria, making this the most critical instruction for early post-transplant safety.

C. Notify the healthcare provider if edema occurs: Edema may signal fluid imbalance or graft dysfunction and should be reported, but it is a secondary concern compared to preventing infection, which can rapidly become life-threatening in immunocompromised individuals.

D. Increase activity and exercise gradually, as tolerated: Gradual resumption of physical activity is important for recovery, but it should be balanced with the need to prevent infection. Infection prevention remains the most urgent teaching point.

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Correct Answer is ["A","C","E"]

Explanation

Rationale:

A. Shaking that changes the child's handwriting legibility: Sudden onset of tremors affecting fine motor skills may indicate a neurological issue, such as a seizure disorder or early signs of a neurological condition, and requires prompt evaluation by the school nurse.

B. Bruises on both knees after the weekend: Bruises on the knees in children are often consistent with normal play and activity. Unless the bruises are unusual in pattern or location (e.g., upper arms, back), they typically do not require immediate referral.

C. Sunburn with blisters on the face, arms, and hands: Blistering sunburns can lead to dehydration, pain, and secondary infection. Facial involvement and blistering elevate the severity and warrant assessment and possible treatment recommendations.

D. Refuses to complete written homework assignments: While this behavior might suggest learning or behavioral challenges, it is not an urgent health issue requiring immediate referral. Teachers should monitor and possibly refer through academic support services, not directly to the nurse.

E. Thirst and frequent requests for bathroom breaks: These symptoms could be early signs of undiagnosed diabetes mellitus and warrant immediate attention from the school nurse to initiate further assessment and notify the child’s guardian.

A. Assess lung sounds for signs of infection. B. Encourage client to initiate a smoking cessation program. C. Administer a prescribed albuterol inhaler. D. Notify the healthcare provider of the low pulse oximetry value.

Correct Answer is C

Explanation

Rationale:

A. Assess lung sounds for signs of infection: While lung assessment is important, there's no indication of fever or increased sputum to suggest infection. It does not immediately relieve the client's current dyspnea.

B. Encourage client to initiate a smoking cessation program: Smoking cessation is vital but is a long-term intervention and not appropriate as the first action for acute shortness of breath following exertion.

C. Administer a prescribed albuterol inhaler: Albuterol acts as a bronchodilator and can relieve acute shortness of breath due to bronchospasm or exertional dyspnea in clients with emphysema. This is the most immediate and appropriate action.

D. Notify the healthcare provider of the low pulse oximetry value: Although communication with the provider may be needed if symptoms persist, the pulse ox of 88% can be common in COPD clients. Immediate symptom relief with the prescribed bronchodilator is the priority.

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The nurse is preparing a discharge teaching plan for a client who had a liver transplant. Which instruction is most important to include in this plan?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The school nurse is preparing a presentation for elementary school teachers to inform them when a child should be referred to the school clinic for further follow-up. The teachers should be instructed to report which situations to the school nurse? Select all that apply.

Correct Answer is ["A","C","E"]

Explanation

Correct Answer is C

Explanation

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