Nokea
A client asks the nurse for information about how to reduce risk factors for benign prostatic hyperplasia (BPH). Which information should the nurse provide?
- A. Consume a high protein diet.
- B. Obtain a prostate-specific antigen blood level test.
- C. Take vitamin supplements.
- D. Increase physical activity.
Correct Answer: D
Rationale: Increasing physical activity helps maintain a healthy weight, lower blood pressure, improve circulation, reduce inflammation, and regulate hormones, reducing BPH risk.
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The nurse is preparing an older client for a magnetic resonance imaging (MRI) with contrast. Which laboratory value should the nurse report to the healthcare provider before the scan is performed?
- A. Fasting blood sugar of 200 mg/dL (11.1 mmol/L).
- B. Glycosylated hemoglobin A1c of 8%.
- C. Blood urea nitrogen of 22 mg/dL (7.9 mmol/L).
- D. Serum creatinine of 1.9 mg/dL (169 umol/L).
Correct Answer: D
Rationale: Serum creatinine of 1.9 mg/dL (169 umol/L) indicates moderate renal insufficiency, which can increase the risk of contrast-induced nephropathy, a sudden deterioration of kidney function after exposure to contrast media used for imaging studies such as MRI. This should be reported to the healthcare provider to assess the risk and benefit of the procedure and to take preventive measures such as hydration or alternative imaging modalities.
In assessing a client with ulcers on the lower extremity, which findings indicate that the ulcers are likely to be of venous, rather than arterial, origin?
- A. Irregular ulcer shapes and severe edema.
- B. Hairless lower extremities and cool feet.
- C. Black ulcers and dependent rubor.
- D. Absent pedal pulses and shiny skin.
Correct Answer: A
Rationale: Irregular ulcer shapes and severe edema are characteristic of venous ulcers, caused by impaired venous return and increased capillary pressure.
Following a motor vehicle accident, a client with chest trauma receives a chest tube to relieve a hemothorax. Two hours following the chest tube insertion, the nurse observes the water level in the water-seal chamber is rising during inspiration and falling during expiration. Which action should the nurse implement?
- A. Lift and clear drainage from the chest tube.
- B. Inspect the tube insertion site for leaking.
- C. Continue to monitor the drainage system.
- D. Auscultate lungs for unequal breath sounds.
Correct Answer: C
Rationale: Continuing to monitor the drainage system is the best action for the nurse to implement, as the water level fluctuations are normal and expected in a water-seal drainage system. The water level should rise during inspiration and fall during expiration, reflecting the changes in intrathoracic pressure.
A client with benign prostatic hyperplasia (BPH) is preparing for discharge following a transurethral needle ablation (TUNA), which information should the nurse include in the discharge instructions?
- A. Use incentive spirometer.
- B. Monitor urinary stream for decrease in output.
- C. Report when hematuria becomes pink tinged.
- D. Restrict physical activities.
Correct Answer: B
Rationale: Monitoring urinary stream for decrease in output is critical to detect urinary retention or obstruction, potential complications of TUNA.
A client with acute renal injury (AKI) weighs 110.3 pounds (50 kg) and has a potassium level of 6.7 mEq/L (6.7 mmol/L) is admitted to the hospital. Which prescribed medication should the nurse administer first?
- A. Sodium polystyrene sulfonate 15 grams by mouth.
- B. Sevelamer one tablet by mouth.
- C. Calcium acetate one tablet by mouth.
- D. Epoetin alfa, recombinant 2,500 units subcutaneously.
Correct Answer: A
Rationale: Sodium polystyrene sulfonate is a medication that binds to excess potassium in the gastrointestinal tract and removes it from the body through feces. It is used to treat hyperkalemia, which is a high level of potassium in the blood. Hyperkalemia can cause cardiac arrhythmias and muscle weakness, and it is a common complication of AKI. Therefore, this medication should be administered first to lower the potassium level and prevent life-threatening complications.