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A client is scheduled for a colonoscopy. Which instruction should the nurse provide?
- A. Eat a light breakfast on the day of the procedure.
- B. You will need to drink a bowel preparation solution before the procedure.
- C. Avoid all liquids for 24 hours before the procedure.
- D. You can continue taking your blood thinners until the day of the procedure.
Correct Answer: B
Rationale: The correct answer is B because drinking a bowel preparation solution helps clear the colon for better visualization during the colonoscopy. This step is crucial to ensure accuracy of the procedure. Choice A is incorrect as the client should have a clear liquid diet the day before the procedure. Choice C is incorrect as hydration is important, but clear liquids are allowed. Choice D is incorrect because blood thinners may need to be adjusted prior to the procedure to reduce bleeding risk.
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A client with heart failure is prescribed digoxin (Lanoxin). Which sign of digoxin toxicity should the nurse teach the client to report?
- A. Increased appetite.
- B. Yellow or blurred vision.
- C. Weight gain.
- D. Nasal congestion.
Correct Answer: B
Rationale: The correct answer is B: Yellow or blurred vision. Digoxin toxicity can lead to visual disturbances, such as yellow or blurred vision, due to its effects on the optic nerve. The nurse should teach the client to report this symptom immediately as it indicates a serious adverse effect. Increased appetite (A), weight gain (C), and nasal congestion (D) are not specific signs of digoxin toxicity and are more commonly associated with other health conditions or side effects of medications. It is crucial for the nurse to emphasize the importance of monitoring and reporting any visual changes to prevent serious complications from digoxin toxicity.
The healthcare provider is caring for a patient who is taking warfarin (Coumadin). Which laboratory value should the healthcare provider monitor closely?
- A. Platelet count.
- B. Prothrombin time (PT).
- C. Hemoglobin level.
- D. White blood cell count.
Correct Answer: B
Rationale: The correct answer is B: Prothrombin time (PT). Warfarin is an anticoagulant medication that works by inhibiting clotting factors. Monitoring PT is essential to ensure the patient's blood is clotting within the desired range to prevent both bleeding and clotting events. Platelet count (A) assesses the quantity of platelets, not the clotting function. Hemoglobin level (C) evaluates red blood cell count and oxygen-carrying capacity. White blood cell count (D) assesses immune function and infection risk, not clotting ability. PT is directly related to warfarin's mechanism of action, making it the most crucial parameter to monitor.
A client with chronic pain is prescribed a fentanyl (Duragesic) patch. Which instruction should the nurse provide to the client?
- A. Apply the patch to a clean, dry, and hairless area of the skin.
- B. Use a heating pad over the patch to enhance absorption.
- C. Change the patch daily to maintain effectiveness.
- D. Place the patch on the same site with each application.
Correct Answer: A
Rationale: The correct answer is A. Applying the fentanyl patch to a clean, dry, and hairless area of the skin ensures proper absorption and effectiveness. Moisture, oils, and hair can interfere with absorption. Option B is incorrect as heating pads can increase drug absorption and lead to overdose. Option C is incorrect because fentanyl patches are usually changed every 72 hours, not daily. Option D is incorrect because rotating application sites helps prevent skin irritation and tolerance development.
A client with chronic kidney disease is prescribed a low-protein diet. Which laboratory result should the nurse monitor to evaluate the effectiveness of the diet?
- A. Blood urea nitrogen (BUN)
- B. Serum potassium
- C. Serum calcium
- D. Creatinine clearance
Correct Answer: A
Rationale: The correct answer is A: Blood urea nitrogen (BUN). BUN is a waste product that reflects protein intake and kidney function. In chronic kidney disease, high protein intake can increase BUN levels, so monitoring BUN helps assess the effectiveness of the low-protein diet.
Incorrect choices:
B: Serum potassium - This is more related to kidney function but not specifically affected by a low-protein diet.
C: Serum calcium - Calcium levels are not directly affected by protein intake or a low-protein diet in chronic kidney disease.
D: Creatinine clearance - This measures kidney function but is not directly influenced by protein intake.
The nurse is planning care for a 16-year-old with juvenile rheumatoid arthritis (JRA). The nurse includes activities to strengthen and mobilize the joints and surrounding muscles. Which physical therapy regimen should the nurse encourage the adolescent to implement?
- A. Exercise in a swimming pool.
- B. Splint affected joints during activity.
- C. Perform passive range of motion exercises twice daily.
- D. Begin a training program of lifting weights and running.
Correct Answer: A
Rationale: The correct answer is A: Exercise in a swimming pool. This option is ideal for a 16-year-old with JRA because it provides a low-impact environment that helps strengthen muscles and improve joint mobility without putting excessive stress on the joints. Swimming also helps reduce pain and stiffness associated with JRA.
Choice B (Splint affected joints during activity) is incorrect because splinting may restrict movement and hinder muscle strengthening. Choice C (Perform passive range of motion exercises twice daily) is not as effective as active exercises in improving muscle strength and joint mobility. Choice D (Begin a training program of lifting weights and running) can be too high-impact and may exacerbate joint inflammation and pain in individuals with JRA.