Nokea
A client has started taking amiodarone (Cordarone). The nurse should inform the client that periodic laboratory tests will be done to monitor the client's:
- A. Hemoglobin.
- B. Liver enzymes.
- C. Creatine kinase (CK) concentration.
- D. Renal function.
Correct Answer: B
Rationale: Amiodarone can cause hepatotoxicity, so periodic monitoring of liver enzymes is necessary to detect potential liver damage.
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During the health history interview, which of the following strategies is the most effective for the nurse to use to help clients feel that they have an active role in their health care?
- A. Ask clients to complete a questionnaire.
- B. Provide clients with written instructions.
- C. Ask clients for their description of events and for their views concerning past medical care.
- D. Ask clients if they have any questions.
Correct Answer: C
Rationale: Engaging clients by asking for their description of events and views on past medical care promotes active participation, fosters trust, and ensures the nurse understands the client's perspective, which is critical for patient-centered care.
A client's laboratory test results reveal a decrease in both serum transferrin and total iron-binding capacity (TIBC). Which disorder is the most likely cause of the client's anemia?
- A. Infection
- B. Malnutrition
- C. Iron deficiency
- D. Sickle cell disease
Correct Answer: B
Rationale: Malnutrition can cause reductions in the serum transferrin and the TIBC. Infection is an unrelated option. Iron-deficiency anemia is usually characterized by decreased iron-binding capacity but increased transferrin levels. Additionally, in clinical practice, the hemoglobin level is routinely used to detect iron-deficiency anemia. Sickle cell anemia is diagnosed by determining that the client has hemoglobin S.
A client with a history of type 2 diabetes is prescribed exenatide (Byetta). The nurse should instruct the client to:
- A. Take the medication before meals.
- B. Monitor for signs of hypoglycemia.
- C. Take the medication at bedtime.
- D. Stop the medication if weight loss occurs.
Correct Answer: A, B
Rationale: Exenatide is taken before meals to control postprandial glucose, and hypoglycemia is a risk.
A client who had undergone an abdominal hysterectomy is in the recovery room. The surgeon has ordered a 250-mL bolus of normal saline over 1 hour to replace blood loss. The I.V. solution infusing in the client was 1,000 mL normal saline with 40 mEq of potassium chloride at 100 mL/hour. The nurse should: Select all that apply.
- A. Increase the I.V. infusion rate to 250 mL/hour for 1 hour.
- B. Add 250 mL of normal saline to the current infusion bag and continue at 100 mL/hour.
- C. Connect a 250-mL bag of normal saline to the Y-connection and calculate to infuse over 1 hour.
- D. Contact the physician regarding continuation of the primary I.V. infusion during the bolus infusion.
- E. Administer the normal saline bolus via an I.V. infusion pump.
Correct Answer: C,E
Rationale: A separate 250-mL bag via Y-connection and infusion pump ensures accurate delivery of the bolus without altering the primary infusion.
You are caring for a postoperative client who is complaining of abdominal distention and flatus. Which intervention would you most likely do for this client?
- A. A cleansing enema
- B. A retention enema
- C. A return-flow enema
- D. A laxative
Correct Answer: C
Rationale: A return-flow enema is specifically used to relieve abdominal distention and flatus by introducing and then removing fluid to stimulate gas expulsion.