Nokea
A client has polycystic kidney disease. The client asks the nurse, 'How did I get these fluid-filled bubbles on my kidneys? I have not had any X-ray type tests.' How should the nurse respond to help the client understand risk factors for this disease process?
- A. Second-hand smoke puts you at greater risk for developing cysts.'
- B. Exposure to dyes used to color fruits and vegetables increases the risk of polycystic kidney disease.'
- C. There is a higher incidence of polycystic kidney disease among blood relatives.'
- D. Drinking alcohol daily allows the kidneys to develop cysts.'
Correct Answer: C
Rationale: Polycystic kidney disease is primarily genetic, with a higher incidence among blood relatives due to autosomal dominant or recessive inheritance patterns.
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A client with a history of type 2 diabetes is prescribed pioglitazone (Actos). The nurse should monitor the client for which of the following adverse effects?
- A. Weight gain.
- B. Hypoglycemia.
- C. Bradycardia.
- D. Hypotension.
Correct Answer: A
Rationale: Pioglitazone can cause weight gain due to fluid retention.
A nurse is assessing a client with a history of myocardial infarction who is in the surgical unit following a gastric resection. The client complains of chest pains. The nurse obtains the electrocardiogram (ECG) shown (see figure). What should the nurse do first?
- A. Administer oxygen.
- B. Inspect the client's incision.
- C. Call the rapid response team.
- D. Reposition the ECG electrodes.
Correct Answer: A
Rationale: Chest pain post-myocardial infarction suggests possible cardiac ischemia, so administering oxygen is the priority to improve oxygenation. The other actions follow after initial stabilization.
A client who is a computer operator has developed carpal tunnel syndrome. The nurse can instruct the client to relieve the pain by managing:
- A. Decreased circulation to the brachial nerve.
- B. Muscle atrophy resulting from disuse.
- C. Median nerve compression.
- D. Progressive flexion contracture of the wrist.
Correct Answer: C
Rationale: Carpal tunnel syndrome results from median nerve compression, and managing this (e.g., with splints or exercises) relieves pain.
You are working as a wound care nurse. You measure the size of a client's wound and it is 3 cm deep, 2 cm long and 4 cm wide. You would document the dimension of this wound as:
- A. 6 cm
- B. 12 cm
- C. 20 cm
- D. 24 cm
Correct Answer: B
Rationale: Wound dimensions are documented as length x width x depth (2 cm x 4 cm x 3 cm), but the total linear measurement is not typically summed. However, based on the options, 12 cm may reflect a misinterpretation; the correct documentation is the individual measurements.
When infusing total parenteral nutrition (TPN), the nurse should assess the client for which of the following complications?
- A. Essential amino acid deficiency.
- B. Essential fatty acid deficiency.
- C. Hyperglycemia.
- D. Infection.
Correct Answer: C,D
Rationale: TPN can cause hyperglycemia due to high glucose content and infection due to catheter use, both requiring vigilant monitoring.