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A nurse is teaching a client who has hypertension and a new prescription for atenolol. Which of the following findings should the nurse include as adverse effects of this medication?
- A. Hyperglycemia
- B. Tachycardia
- C. Hypertension
- D. Bradycardia
Correct Answer: D
Rationale: The correct answer is D: Bradycardia. Atenolol is a beta-blocker that slows down the heart rate, leading to bradycardia as an adverse effect. This occurs because atenolol blocks the action of adrenaline on the heart, causing the heart to beat slower. Hyperglycemia (A) is not a common adverse effect of atenolol; in fact, it may even lower blood sugar levels slightly. Tachycardia (B) and hypertension (C) are the opposite effects of atenolol, as it is used to treat high blood pressure and reduce heart rate. Therefore, these would not be expected adverse effects.
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A nurse is caring for a client who is experiencing menopausal symptoms and asks the nurse about menopausal hormone therapy (HT). The nurse should inform the client that HT is not recommended due to which of the following findings in the client's medical history?
- A. History of breast cancer
- B. History of hypertension
- C. History of diabetes
- D. History of osteoarthritis
Correct Answer: A
Rationale: The correct answer is A: History of breast cancer. Menopausal hormone therapy (HT) is contraindicated in women with a history of breast cancer due to the potential risk of hormone-dependent cancer recurrence. Hormones can stimulate the growth of estrogen-sensitive breast cancer cells, increasing the risk of cancer recurrence. Therefore, it is crucial for the nurse to inform the client with a history of breast cancer that HT is not recommended. Choices B, C, and D are not directly contraindications for HT in menopausal clients, as long as these conditions are well-controlled and monitored.
A nurse is teaching a client with Addison's disease about its cause. What should the nurse say?
- A. It is caused by the overproduction of growth hormone.
- B. It is caused by the lack of production of aldosterone by the adrenal gland.
- C. It is caused by excess thyroid hormone.
- D. It is caused by overactive adrenal glands.
Correct Answer: B
Rationale: The correct answer is B: Addison's disease is caused by the lack of production of aldosterone by the adrenal gland. Aldosterone is a hormone produced by the adrenal glands that helps regulate blood pressure and electrolyte balance in the body. In Addison's disease, the adrenal glands do not produce enough aldosterone, leading to symptoms like low blood pressure, weakness, and electrolyte imbalances. Choice A is incorrect because Addison's disease is not caused by the overproduction of growth hormone. Choice C is incorrect as it mentions excess thyroid hormone, which is not related to Addison's disease. Choice D is incorrect because Addison's disease is characterized by underactive, not overactive, adrenal glands.
A nurse is caring for a client receiving TPN. What action should the nurse take?
- A. Monitor serum sodium levels daily.
- B. Check the client's capillary blood glucose level every 4 hr.
- C. Administer the solution at room temperature.
- D. Discontinue abruptly if the client reports nausea.
Correct Answer: B
Rationale: The correct answer is B: Check the client's capillary blood glucose level every 4 hr. This is crucial because TPN can cause hyperglycemia due to its high glucose content. Monitoring blood glucose levels helps in detecting and managing hyperglycemia.
Incorrect answers:
A: Monitoring serum sodium levels is not directly related to TPN administration.
C: Administering the solution at room temperature is not necessary for TPN administration.
D: Discontinuing TPN abruptly can lead to serious complications; it should be gradually tapered off.
Overall, monitoring blood glucose levels is essential in TPN therapy to prevent complications related to hyperglycemia.
A nurse is caring for a client who has HIV. Which of the following laboratory values is the nurse's priority?
- A. Hemoglobin of 12 g/dL
- B. Platelet count of 350,000/mm3
- C. CD4-T-cell count 180 cells/mm3
- D. White blood cell count of 10,000/mm3
Correct Answer: C
Rationale: The correct answer is C: CD4-T-cell count 180 cells/mm3. In HIV care, monitoring the CD4-T-cell count is crucial as it reflects the immune system's ability to fight infections. A low CD4 count indicates a weakened immune system, increasing the client's susceptibility to opportunistic infections. This value guides treatment decisions, such as initiating antiretroviral therapy. The other options, while important, do not directly reflect the client's immune status in the context of HIV. Hemoglobin and platelet counts are relevant for assessing anemia and clotting function, respectively. White blood cell count is a general indicator of infection or inflammation. Prioritizing CD4-T-cell count ensures appropriate management of HIV and prevention of complications.
A nurse is reviewing the laboratory data of a client who has acute pancreatitis. The nurse should expect to find an elevation of which of the following values?
- A. Creatinine
- B. Bilirubin
- C. Amylase
- D. Albumin
Correct Answer: C
Rationale: The correct answer is C: Amylase. In acute pancreatitis, there is inflammation of the pancreas leading to leakage of pancreatic enzymes like amylase into the blood. Elevated amylase levels are a hallmark of acute pancreatitis. Creatinine (A) is related to kidney function, bilirubin (B) to liver function, and albumin (D) to protein status. In acute pancreatitis, the focus is on pancreatic enzymes like amylase.