Nokea
A client has been on antibiotics for 72 hours for cystitis. Which report from the client requires priority attention by the nurse?
- A. foul smelling urine
- B. burning on urination
- C. elevated temperature
- D. nausea and anorexia
Correct Answer: C
Rationale: Elevated temperature after 72 hours on an antibiotic indicates the antibiotic has not been effective in eradicating the offending organism. The provider should be informed immediately so that an appropriate medication can be prescribed, and complications such as pyelonephritis are prevented.
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For proper foot care, the nurse should provide a patient with non-insulin dependent mellitus with instructions to:
For proper foot care, the nurse should provide a patient with non-insulin dependent mellitus with instructions to:
- A. Remove all corns and stop smoking.
- B. Always wear shoes and use natural fiber socks.
- C. Wear nylon socks and wash feet in warm water.
- D. Wear shoes that are slightly larger and avoid corn removers.
Correct Answer: B
Rationale: Wearing shoes and natural fiber socks protects diabetic feet and promotes circulation.
The incidence of spinal cord defects/ neural tube defects such as meningomyelocele
The incidence of spinal cord defects/ neural tube defects such as meningomyelocele has decreased because
- A. prenatal diagnosis by ultrasound and treatment in the uterus.
- B. maternal ingestion of folic acid prior and during pregnancy.
- C. decreased incidence of smoking and alcohol use during pregnancy.
- D. genetic testing prior to pregnancy.
Correct Answer: B
Rationale: Folic acid supplementation reduces neural tube defects by supporting neural tube closure.
A nurse is to present information about Chinese folk medicine to a group of student nurses. Based on this cultural belief system, the nurse would explain that illness is attributed to the
- A. Yang, the positive force that represents light, warmth, and fullness
- B. Yin, the negative force that represents darkness, cold, and emptiness
- C. Use of improper hot foods, herbs and plants
- D. A failure to keep life in balance with nature and others
Correct Answer: B
Rationale: Yin, the negative force that represents darkness, cold, and emptiness. Excessive Yin is believed to cause illness in Chinese folk medicine.
Priority nursing diagnosis on the patient who was admitted with acute renal failure
Priority nursing diagnosis on the patient who was admitted with acute renal failure would be:
- A. Bed rest to conserve oxygen.
- B. Increase fluid intake to promote urination.
- C. Fatigue due to altered nutrition.
- D. Dehydration secondary to diuresis.
Correct Answer: C
Rationale: Fatigue due to altered nutrition is a priority in acute renal failure as it reflects metabolic imbalances and nutritional deficits.
The nurse is caring for a client with a history of chronic kidney disease who is receiving hemodialysis. Which of the following findings would require immediate intervention?
- A. Blood pressure of 140/90 mmHg.
- B. Weight gain of 1 kg since last dialysis.
- C. Bright red blood in the dialysis tubing.
- D. Potassium level of 4.5 mEq/L.
Correct Answer: C
Rationale: Bright red blood in the dialysis tubing indicates a potential access site bleed or tubing disconnection, requiring immediate intervention to prevent blood loss. Mild hypertension (A) and weight gain (B) are common, and a normal potassium level (D) is unremarkable.