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A 57-year-old with diabetes insipidus is hospitalized for care. Which finding should the nurse report to the physician?
- A. Urine output of 350 mL in 8 hours.
- B. Urine specific gravity of 1.001.
- C. Potassium of 4.0 mEq.
- D. Weight gain.
Correct Answer: B
Rationale: Diabetes insipidus causes excessive dilute urine output. A urine specific gravity of 1.001 (very dilute) indicates worsening of the condition and should be reported. The other findings are within normal or expected ranges.
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A client who underwent a lobectomy and has a water-seal chest drainage system is breathing with a little more effort and at a faster rate than 1 hour ago. The client's pulse rate is also increased. The nurse should:
- A. Check the tubing to ensure that the client is not lying on it or kinking it.
- B. Increase the suction.
- C. Lower the drainage bottles 2 to 3 feet below the level of the client's chest.
- D. Ensure that the chest tube has two clamps on it to prevent air leaks.
Correct Answer: A
Rationale: Increased respiratory effort, rate, and pulse suggest a possible obstruction; checking for kinked or compressed tubing is the first step. Increasing suction, lowering bottles, or clamping tubes risks worsening the issue.
A client with acute renal failure has a low calcium level. The nurse should monitor for:
- A. Tetany.
- B. Hypertension.
- C. Bradycardia.
- D. Edema.
Correct Answer: A
Rationale: Low calcium can cause tetany, manifesting as muscle cramps or spasms.
A client receiving chemotherapy has experienced a flare-up of pruritus. In order to develop a care plan, the nurse should ask the client if she has been:
- A. Wearing clothes made from 100% cotton.
- B. Sleeping in a cool, humidified room.
- C. Increasing fluid intake to at least 3,000 mL/day.
- D. Taking daily baths with a deodorant soap.
Correct Answer: B
Rationale: Sleeping in a cool, humidified room can reduce pruritus by preventing skin dryness, which is a key factor in developing an effective care plan.
The nurse is caring for a client who has been prescribed naproxen. Which condition in the client's medical history would require clarification with the primary healthcare provider (PHCP)?
- A. Rheumatoid arthritis (RA)
- B. Congestive heart failure (CHF)
- C. Osteoarthritis
- D. Psoriatic arthritis
Correct Answer: B
Rationale: Naproxen, an NSAID, can exacerbate congestive heart failure by causing fluid retention and increasing cardiac workload.
A hospice client's family asks how they will know when death is imminent. The nurse should explain that signs include:
- A. Increased energy and mobility.
- B. Cheyne-Stokes respirations.
- C. Improved blood pressure.
- D. Clear lung sounds.
Correct Answer: B
Rationale: Cheyne-Stokes respirations, characterized by alternating periods of apnea and deep breathing, are a common sign of imminent death.