Nokea
After educating a client with hypertension secondary to renal disease, the nurse assesses the client's understanding. Which statement made by the client indicates a need for additional teaching?
- A. I can prevent more damage to my kidneys by managing my blood pressure.
- B. If I have increased urination at night, I need to drink less fluid during the day.
- C. I need to see the registered dietitian to discuss limiting my protein intake.
- D. It is important that I take my antihypertensive medications as directed.
Correct Answer: B
Rationale: Choice B is incorrect because the client should not restrict fluids during the day due to increased urination at night. Clients with renal disease may be prescribed fluid restrictions, and they should be thoroughly assessed for potential dehydration. To decrease increased nocturnal voiding, clients should consume fluids earlier in the day. Choices A, C, and D are correct statements. Managing blood pressure is crucial to slow the progression of renal dysfunction. Limiting protein intake is important in renal disease management, and clients should be referred to a dietitian as needed. Taking antihypertensive medications as directed is essential for blood pressure control.
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A client has the following arterial blood gas (ABG) results: pH 7.51, PCO2 31 mm Hg, PO2 94 mm Hg, HCO3 24 mEq/L. Which of the following acid-base disturbances does the nurse recognize in these results?
- A. Metabolic acidosis
- B. Metabolic alkalosis
- C. Respiratory acidosis
- D. Respiratory alkalosis
Correct Answer: D
Rationale: The ABG results show a pH above the normal range (7.35-7.45) and a decreased PCO2, indicating respiratory alkalosis. In respiratory alkalosis, the pH is increased and the PCO2 is decreased. Metabolic acidosis (choice A) would present with a low pH and low HCO3 levels. Metabolic alkalosis (choice B) would show an increased pH and HCO3 levels. Respiratory acidosis (choice C) would have a low pH and an increased PCO2.
A nurse is conducting an assessment of a client who underwent thoracentesis of the right side of the chest 3 hours ago. Which findings does the nurse report to the physician? Select all that apply.
- A. Unequal chest expansion
- B. Pulse rate of 82 beats/min
- C. Respiratory rate of 22 breaths/min
- D. Diminished breath sounds in the right lung
Correct Answer: A
Rationale: After thoracentesis, the nurse should assess the client for signs of pneumothorax, which include increased respiratory rate, dyspnea, retractions, unequal chest expansion, diminished breath sounds, and cyanosis. Unequal chest expansion is a key sign of pneumothorax due to the accumulation of air in the pleural space, causing the affected lung to collapse partially. Pulse rate and respiratory rate within normal ranges, like in choices B and C, are not the priority findings to report in this situation. Diminished breath sounds in the right lung could be expected after thoracentesis and may not necessarily indicate a complication like pneumothorax, making choice D less urgent to report.
A client is unsure of the decision to undergo peritoneal dialysis (PD) and wishes to discuss the advantages of this treatment with the nurse. Which statements by the nurse are accurate regarding PD? (Select all that apply.)
- A. You will not need vascular access to perform PD.
- B. There is less restriction of protein and fluids.
- C. You have flexible scheduling for the exchanges.
- D. All of the above
Correct Answer: D
Rationale: The correct answer is D, as all the statements are accurate advantages of peritoneal dialysis (PD). Peritoneal dialysis does not require vascular access, offers less restriction on protein and fluids, and provides flexibility in scheduling for the exchanges. Choice A is correct because one of the advantages of PD is not needing vascular access, which is required in hemodialysis. Choice B is correct because PD allows for less dietary restriction compared to hemodialysis. Choice C is correct because PD allows for flexible scheduling of exchanges, providing more independence to the individual undergoing treatment.
A client with functional urinary incontinence is being taught by a nurse. Which statement should the nurse include in this client's teaching?
- A. Clean around your catheter daily with soap and water.
- B. Wash the vaginal weights with a 10% bleach solution after each use.
- C. Informing about available operations to repair your bladder.
- D. Buy slacks with elastic waistbands that are easy to pull down.
Correct Answer: D
Rationale: Functional urinary incontinence is not related to bladder issues but rather to difficulties with ambulation or accessing the toilet. The goal is to help the client manage clothing independently. Elastic waistband slacks that are easy to pull down facilitate timely access to the toilet. Choices A and B are unrelated and not applicable to functional urinary incontinence. Choice C is incorrect as surgeries to repair the bladder are not indicated for functional urinary incontinence.
A client in a physician's office has just made an appointment for an exercise stress test. The client should be instructed to:
- A. Wear sweatpants and a heavy sweatshirt
- B. Eat a small meal just before the procedure
- C. Wear comfortable rubber-soled shoes such as sneakers
- D. Avoid consuming caffeine for 30 minutes before the procedure
Correct Answer: C
Rationale: The client should wear comfortable rubber-soled shoes, such as sneakers, for the exercise stress test. This choice ensures safety and stability during the procedure. Wearing sweatpants and a heavy sweatshirt (Choice A) would not be appropriate as the client needs to wear light, loose, comfortable clothing. Eating a small meal just before the procedure (Choice B) could lead to discomfort during the test. Avoiding caffeine for 30 minutes before the procedure (Choice D) is not a specific instruction related to the attire or preparation for the test.