Nokea
A client in a provider's office tells the nurse that, 'I fast for several days each week to help control my weight.' The client takes several medications for various chronic issues. The nurse should explain to the client that which of the following mechanisms that result from fasting puts her at risk for medication toxicity?
- A. Increasing the metabolism of the medications over time
- B. Increasing the protein-binding response
- C. Increasing medications' transit time through the intestines
- D. Decreasing the excretion of medications
Correct Answer: B
Rationale: Fasting can lead to an increased protein-binding response of medications. This can result in a higher concentration of bound medications in the bloodstream, potentially causing toxicity as the medications may not be readily available for metabolism or excretion. Choice A is incorrect because fasting typically doesn't increase medication metabolism. Choice C is incorrect as fasting usually decreases transit time through the intestines. Choice D is incorrect since fasting generally does not decrease medication excretion.
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A nurse is caring for a young adult at a college health clinic. Which of the following actions should the nurse take first?
- A. Give the client information about immunization against meningitis.
- B. Tell the client to have a TB skin test every 2 years.
- C. Determine the client's health risks.
- D. Teach the client about exercise recommendations.
Correct Answer: C
Rationale: Assessing the client's health risks is the priority as it provides essential information to guide subsequent care. By understanding the client's health risks, the nurse can tailor health education and interventions, such as immunizations and lifestyle modifications, to address specific needs. Providing information about immunization against meningitis (Choice A) is important but should come after assessing health risks. Instructing the client to have a TB skin test every 2 years (Choice B) is relevant but not the initial step in care. Teaching about exercise recommendations (Choice D) is also essential but should follow the assessment of health risks.
A client is admitted with a diagnosis of septicemia. Which assessment finding should the LPN/LVN report to the healthcare provider immediately?
- A. Increased urine output
- B. Decreased blood pressure
- C. Increased heart rate
- D. Increased respiratory rate
Correct Answer: B
Rationale: In a client with septicemia, decreased blood pressure is a critical finding that suggests potential septic shock, a life-threatening condition. Septic shock requires immediate medical intervention to prevent further deterioration and organ dysfunction. Increased urine output (Choice A) may indicate adequate fluid resuscitation, which is a positive response. Increased heart rate (Choice C) and increased respiratory rate (Choice D) are common physiological responses to sepsis and do not necessarily indicate immediate life-threatening complications like decreased blood pressure does in septic shock.
A nurse is caring for a client receiving fluid through a peripheral IV catheter. Which of the following findings at the IV site should the nurse identify as infiltration?
- A. purulent exudate
- B. warmth
- C. skin blanching
- D. bleeding
Correct Answer: C
Rationale: Infiltration occurs when the IV fluid leaks into the surrounding tissue instead of entering the bloodstream properly. Skin blanching, swelling, and coolness at the IV site are typical signs of infiltration. Purulent exudate (choice A) is associated with infection, warmth (choice B) can indicate phlebitis, and bleeding (choice D) may occur if the IV catheter punctures a blood vessel.
A nurse is caring for an older adult client who becomes agitated when the nurse requests the client's dentures be removed prior to surgery. Which of the following responses should the nurse make?
- A. You seem worried. Are you concerned someone may see you without your teeth?
- B. Don't worry, it's just for the surgery.
- C. You need to follow the instructions.
- D. The dentures need to be removed for a reason.
Correct Answer: D
Rationale: The correct response is to provide a clear rationale for the request, as stated in option D. By explaining the purpose behind removing the dentures, the nurse helps the client understand the necessity, which can reduce agitation and promote cooperation. Option A demonstrates empathy by addressing the client's potential concern about being seen without dentures but lacks a direct explanation. Option B dismisses the client's feelings with a casual statement that may not address the underlying issue. Option C is authoritarian and lacks empathy, potentially escalating the client's agitation.
When admitting a client to an acute care facility, an identification bracelet is sent up with the admission form. In the event these do not match, the nurse's best action is to
- A. Change whichever item is incorrect to the correct information
- B. Use the bracelet and admission form until a replacement is supplied
- C. Notify the admissions office and wait to apply the bracelet
- D. Make a corrected identification bracelet for the client
Correct Answer: C
Rationale: The nurse should notify the admissions office and wait to apply the bracelet. By doing so, the nurse ensures patient safety and accuracy in identification. Changing the incorrect item (Choice A) could lead to errors and confusion in the patient's identification. Using the mismatched items until a replacement is supplied (Choice B) compromises patient safety and could result in errors during care delivery. Making a corrected identification bracelet without verifying the correct information (Choice D) could introduce further inaccuracies and risks in patient identification.