Nokea
A client has developed diabetes insipidus after removal of a pituitary tumor. Which finding would the nurse expect?
- A. Polyuria
- B. Hypertension
- C. Polyphagia
- D. Hyperkalemia
Correct Answer: A
Rationale: Diabetes insipidus causes polyuria due to deficient antidiuretic hormone, leading to excessive water loss. Hypertension (B), polyphagia (C), and hyperkalemia (D) are not typical.
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A successful executive left her job and became a housewife after her marriage to a plastic surgeon. She started doing volunteer work for a charity organization. She developed pain in her legs that advanced to the point of paralysis. Her physicians can find no organic basis for the paralysis. The client's behavior can be described as:
- A. Housework phobia
- B. Malingering
- C. Conversion reaction
- D. Agoraphobia
Correct Answer: C
Rationale: A conversion reaction is a physical expression of an emotional conflict with no organic basis, such as paralysis in this case.
A client with a history of gout is receiving Allopurinol (Zyloprim). The nurse should teach the client to:
- A. Increase fluid intake
- B. Avoid dairy products
- C. Take the medication on an empty stomach
- D. Limit protein intake
Correct Answer: A
Rationale: Allopurinol reduces uric acid, and increased fluid intake promotes uric acid excretion, preventing kidney stones. Dairy, empty stomach, and protein limits are not necessary.
The nurse is caring for a client with a brain tumor who has been prescribed levofloxacin (Levaquin) for a sinus infection. What specific instructions should be included when educating the client regarding taking this drug?
- A. Avoid direct sunlight.
- B. Report unexplained joint pain.
- C. No antacids should be taken within 2 hours of taking the drug.
- D. Take the medication on an empty stomach.
- E. Keep the head of the bed elevated for 30 minutes after taking.
Correct Answer: A, B, C
Rationale: Levofloxacin requires avoiding sunlight (A) due to photosensitivity, reporting joint pain (B) for tendonitis risk, and avoiding antacids (C) to ensure absorption. Empty stomach (D) is optional, and bed elevation (E) is unrelated.
Which of the following nursing care goals has the highest priority for a child with epiglottitis?
- A. Sleep or lie quietly 10 hr/day.
- B. Consume foods from all four food groups.
- C. Be afebrile throughout her hospital stay.
- D. Participate in play activities 4 hr/day.
Correct Answer: A
Rationale: Of these four goals, maintenance of a calm, quiet atmosphere to reduce anxiety and to allow for rest is the most important. Although nutrition is important, the child needs fluids to maintain fluid and electrolyte balance more than solid foods. In addition, the child may not be able to swallow solid foods owing to epiglottic swelling. This goal is unrealistic because fever is a common symptom of the infection associated with epiglottitis. If overexerted, the child will need more O2 and energy than available, and these requirements may exacerbate the condition.
A 43-year-old client is admitted to the hospital with a diagnosis of peripheral vascular disorder. She arrives in her room via stretcher and requires assistance to move to her bed. The nurse notes that her left leg is cold to touch. She complains of having recently experienced muscle spasms in that leg. To determine if these muscle spasms are indicative of intermittent claudication, the nurse would begin her assessment with the following question:
- A. Would you describe the intensity, duration, and symptoms associated with your pain?
- B. Do you experience swelling at the end of the day in the affected and unaffected leg?
- C. Have you had any lesions of the affected leg that have been difficult to heal?
- D. Do your muscle spasms occur following rest, walking, or exercising?
Correct Answer: D
Rationale: Describing pain is an important aspect of the assessment; however, assessing activity preceding muscle spasms is equally important. Edema may occur with peripheral vascular disease, but it is not of particular importance in assessing intermittent claudication. Lesions may be present with peripheral vascular disease, but they are not an indication of intermittent claudication. With intermittent claudication, muscle spasms occur intermittently, mainly with walking and after exercising. Rest may relieve muscle spasms.