Nokea
A client who has gout is most likely to form which type of renal calculi?
- A. Struvite stones
- B. Staghorn calculi
- C. Uric acid stones
- D. Calcium stones
Correct Answer: C
Rationale: The presence of urinary tract infection is a factor in the formation of struvite stones. Staghorn calculi is the other name for struvite stones associated with urinary tract infection. Clients who have gout form uric acid stones. Clients who have increased urinary excretion of calcium form calcium stones.
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A 45-year-old male client was admitted to a chemical dependency treatment center following legal problems related to alcohol abuse. He states, 'I know that alcohol is a problem for some people, but I can stop whenever I want to. I'm never sick or miss work, and no one can complain about me.' During the initial assessment, the best response by the nurse would be:
- A. The fact is you are an alcoholic or you wouldn't be here.
- B. I understand it took strength to admit yourself to the unit, and I will do my part to help you to stay alcohol-free.
- C. If you can stop drinking when you want to, why don't you stop?
- D. It's good that you can stop drinking when you want to.
Correct Answer: B
Rationale: Direct confrontation initially is nontherapeutic and may result in the client becoming frustrated and wanting to leave. A positive, supportive attitude builds trust, and identifying positive strength raises self-esteem. Offering help allows the client to feel that he is not alone in dealing with problems. Asking the client why or to give an explanation for his behavior puts him in a position of having to justify his behavior to the nurse. Giving approval or placing a value on feelings or a behavior may limit the client's freedom to behave in a way that may displease another. This response may lead to seeking praise instead of progress.
The child with seizure disorder is being treated with phenytoin (Dilantin). Which of the following statements by the patient's mother indicates to the nurse that the patient is experiencing a side effect of Dilantin therapy?
- A. She is very irritable lately.'
- B. She sleeps quite a bit of the time.'
- C. Her gums look too big for her teeth.'
- D. She has gained about 10 pounds in the last six months.'
Correct Answer: C
Rationale: Gingival hyperplasia (overgrown gums) is a common side effect of phenytoin (Dilantin). Irritability, excessive sleep, and weight gain are not typical side effects of this medication.
A client hospitalized with cirrhosis has developed abdominal ascites. The nurse should provide the client with snacks that provide additional:
- A. Sodium
- B. Potassium
- C. Protein
- D. Fat
Correct Answer: C
Rationale: Ascites in cirrhosis is linked to hypoalbuminemia; increasing protein intake helps restore albumin levels, reducing fluid accumulation.
Upon arrival to the nursery, Ilotycin (erythromycin) eyedrops are instilled in the newborn's eyes. The nurse understands that the medication will:
- A. Make the eyes less sensitive to light
- B. Help prevent neonatal blindness
- C. Strengthen the muscles of the eyes
- D. Improve accommodation to near objects
Correct Answer: B
Rationale: Erythromycin eyedrops are used prophylactically in newborns to prevent ophthalmia neonatorum, which can cause blindness.
The nurse is caring for a client following a cerebral vascular accident. Which portion of the brain is responsible for changes in the client's vision?
- A. Temporal lobe
- B. Frontal lobe
- C. Occipital lobe
- D. Parietal lobe
Correct Answer: C
Rationale: The occipital lobe processes visual information. A cerebral vascular accident affecting this area can cause visual deficits such as hemianopia or visual agnosia. The temporal lobe manages auditory and memory functions, the frontal lobe controls behavior and motor skills, and the parietal lobe handles sensory integration.