Nokea
The nurse is screening clients for those at risk of developing nephrolithiasis. Which of the following factors would increase a client's risk of developing nephrolithiasis?
- A. gout
- B. dehydration
- C. hypokalemia
- D. thrombocytopenia
- E. hyperparathyroidism
Correct Answer: A,B,E
Rationale: Gout (A), dehydration (B), and hyperparathyroidism (E) increase nephrolithiasis risk due to uric acid, concentrated urine, and calcium imbalances, respectively. Hypokalemia (C) and thrombocytopenia (D) are unrelated.
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The nurse is assessing a young child at a clinic visit for a mild respiratory infection. Koplik spots are noted on the oral mucous membranes. The nurse should then assess which area of the body?
- A. The skin
- B. The lungs
- C. The muscles
- D. Bowel and bladder
Correct Answer: A
Rationale: The skin. A characteristic sign of rubeola is Koplik spots (small red spots with a bluish white center). These are found on the buccal mucosa about 2 days before and after the onset of the measles rash.
The nurse is caring for a child newly diagnosed with cystic fibrosis. What interventions does the nurse expect to be included in the client's multidisciplinary plan of care?
- A. Chest physiotherapy
- B. Genetic counseling
- C. Low-calorie diet
- D. Oral fluid restriction
- E. Spiritual support
Correct Answer: A,B,E
Rationale: Chest physiotherapy (A) clears mucus, genetic counseling (B) addresses hereditary aspects, and spiritual support (E) aids coping. A high-calorie diet, not low-calorie (C), is needed for nutrition. Fluid restriction (D) is inappropriate, as hydration is encouraged.
The nurse is caring for a client with heart failure who develops a persistent, dry cough after starting enalapril. Which of the following new prescriptions would the nurse anticipate for this client?
- A. Alprazolam
- B. Guaifenesin
- C. Lisinopril
- D. Valsartan
Correct Answer: D
Rationale: A dry cough is a common side effect of ACE inhibitors like enalapril, so switching to an ARB like valsartan (D) is anticipated. Alprazolam (A), guaifenesin (B), and lisinopril (C, another ACE inhibitor) are inappropriate.
The nurse is reviewing a nutritional plan for a 6-month-old who has recently been started on solid foods. Which of the following recommendations has the highest priority in the plan?
- A. Canned baby food is more expensive than food prepared at home
- B. Finger foods can be introduced before the child has teeth
- C. New foods should be introduced at least 5-7 days apart
- D. Rice cereal can be mixed with cow's milk to increase nutritional intake
Correct Answer: C
Rationale: Introducing new foods 5-7 days apart (C) prevents allergic reactions by identifying triggers, making it the priority. Cost (A), finger foods (B), and cow's milk (D, not recommended before 12 months) are secondary.
There has been a large-scale community disaster and clients must be roomed together at the hospital. Who are appropriate roommates in light of infection risk principles?
- A. A client diagnosed with varicella and a client with pertussis
- B. A client placed in an airborne infection isolation room (AIIR) and a client with heart failure
- C. A client receiving chemotherapy and a client with chronic obstructive pulmonary disease (COPD) coughing yellow sputum
- D. A client with pelvic inflammatory disease (PID) and a client with coffee ground emesis
- E. Two clients diagnosed with tuberculosis
Correct Answer: D
Rationale: PID and coffee ground emesis (D) are non-infectious, making them suitable roommates. Varicella, pertussis, TB (A, E), and COPD with sputum (C) pose infection risks. AIIR (B) is for airborne infections, incompatible with heart failure.