Nokea
A client is unsure of the decision to undergo peritoneal dialysis (PD) and wishes to discuss the advantages of this treatment with the nurse. Which statements by the nurse are accurate regarding PD? (Select all that apply.)
- A. You will not need vascular access to perform PD.
- B. There is less restriction of protein and fluids.
- C. You have flexible scheduling for the exchanges.
- D. All of the above
Correct Answer: D
Rationale: The correct answer is D, as all the statements are accurate advantages of peritoneal dialysis (PD). Peritoneal dialysis does not require vascular access, offers less restriction on protein and fluids, and provides flexibility in scheduling for the exchanges. Choice A is correct because one of the advantages of PD is not needing vascular access, which is required in hemodialysis. Choice B is correct because PD allows for less dietary restriction compared to hemodialysis. Choice C is correct because PD allows for flexible scheduling of exchanges, providing more independence to the individual undergoing treatment.
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A patient who is taking trimethoprim-sulfamethoxazole (TMP-SMX) calls to report developing an all-over rash. What action should the nurse instruct the patient to perform?
- A. Increase fluid intake.
- B. Take diphenhydramine.
- C. Stop taking TMP-SMX immediately.
- D. Continue taking the medication.
Correct Answer: C
Rationale: When a patient develops an all-over rash while taking trimethoprim-sulfamethoxazole (TMP-SMX), it may indicate a serious drug reaction. In this case, the patient should stop taking the medication immediately and notify their healthcare provider. Increasing fluid intake (Choice A) may be beneficial in some cases but is not the priority when a serious drug reaction is suspected. Taking diphenhydramine (Choice B) may help with itching but does not address the underlying issue of a potential drug reaction. Continuing the medication (Choice D) is not advisable when a serious adverse reaction such as a widespread rash occurs.
The patient is beginning furosemide and has started a 2-week course of a steroid medication. What should the nurse recommend?
- A. Avoid consuming licorice to prevent excess potassium loss.
- B. Report a urine output less than 600 mL/24 hours.
- C. Obtain an order for a potassium supplement.
- D. Take the furosemide in the morning.
Correct Answer: C
Rationale: When a patient is taking furosemide and a steroid medication, there is an increased risk of potassium loss due to the interaction between the two drugs. Consuming licorice should be avoided as it can worsen potassium loss. Reporting a urine output less than 600 mL/24 hours is not directly related to the drug interaction and may not be necessary. Taking furosemide at bedtime is not the primary concern when a patient is concurrently on a steroid medication and furosemide. Therefore, obtaining an order for a potassium supplement is the most appropriate recommendation to counteract the potential potassium loss.
A patient is admitted to the hospital for treatment of pneumonia after complaining of high fever and shortness of breath. The patient was not able to produce sputum for a culture. The nurse will expect the patient's provider to order
- A. a broad-spectrum antibiotic.
- B. a narrow-spectrum antibiotic.
- C. multiple antibiotics.
- D. the pneumococcal vaccine.
Correct Answer: A
Rationale: In this scenario where the offending organism causing pneumonia is unknown due to the inability to produce sputum for culture, the appropriate choice is a broad-spectrum antibiotic. Broad-spectrum antibiotics are effective against a wide range of bacteria and are commonly used when the specific pathogen is unidentified. Narrow-spectrum antibiotics target specific types of bacteria and are chosen based on culture and sensitivity results. Using multiple antibiotics without a clear indication from culture and sensitivity testing can lead to antibiotic resistance and is not recommended in this situation. Additionally, the pneumococcal vaccine is preventive and does not treat an ongoing infection like pneumonia.
A client with functional urinary incontinence is being taught by a nurse. Which statement should the nurse include in this client's teaching?
- A. Clean around your catheter daily with soap and water.
- B. Wash the vaginal weights with a 10% bleach solution after each use.
- C. Informing about available operations to repair your bladder.
- D. Buy slacks with elastic waistbands that are easy to pull down.
Correct Answer: D
Rationale: Functional urinary incontinence is not related to bladder issues but rather to difficulties with ambulation or accessing the toilet. The goal is to help the client manage clothing independently. Elastic waistband slacks that are easy to pull down facilitate timely access to the toilet. Choices A and B are unrelated and not applicable to functional urinary incontinence. Choice C is incorrect as surgeries to repair the bladder are not indicated for functional urinary incontinence.
The healthcare provider is caring for a patient who is receiving an intravenous antibiotic. The patient has a serum drug trough of 1.5 mcg/mL. The normal trough for this drug is 1.7 mcg/mL to 2.2 mcg/mL. What will the healthcare provider expect the patient to experience?
- A. Inadequate drug effects
- B. Increased risk of superinfection
- C. Minimal adverse effects
- D. Slowed onset of action
Correct Answer: A
Rationale: A serum drug trough level below the normal range (1.7 mcg/mL to 2.2 mcg/mL) indicates that the medication concentration is insufficient to provide therapeutic effects, leading to inadequate drug effects. A low trough level does not directly correlate with an increased risk of superinfection, minimal adverse effects, or a slowed onset of action, as these are more related to the drug's concentration within the therapeutic range.