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A client with a diagnosis of hypertension is prescribed a thiazide diuretic. Which potential side effect should the nurse monitor for?
- A. Hyperkalemia
- B. Hypernatremia
- C. Hypokalemia
- D. Hypoglycemia
Correct Answer: C
Rationale: The correct answer is C: 'Hypokalemia.' Thiazide diuretics commonly cause potassium loss, which can lead to hypokalemia. Monitoring potassium levels is essential when a client is taking thiazide diuretics to prevent complications such as cardiac dysrhythmias. Choices A, B, and D are incorrect. Hyperkalemia (choice A) is an elevated level of potassium, which is not typically associated with thiazide diuretics. Hypernatremia (choice B) is an elevated level of sodium, and hypoglycemia (choice D) is low blood sugar, neither of which are directly linked to thiazide diuretic use.
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A hospitalized toddler who is recovering from a sickle cell crisis holds a toy and says, 'Mine.' According to Erikson's theory of psychosocial development, this child's behavior is a demonstration of which developmental stage?
- A. Autonomy vs. Shame and Doubt
- B. Industry vs. Inferiority
- C. Initiative vs. Guilt
- D. Trust vs. Mistrust
Correct Answer: A
Rationale: The toddler's behavior of asserting possession ('Mine') reflects a desire for independence, aligning with Erikson's stage of Autonomy vs. Shame and Doubt. This stage, typical for toddlers aged 1-3 years, focuses on developing a sense of control and independence. Choices B, C, and D are incorrect: Industry vs. Inferiority relates to middle childhood, Initiative vs. Guilt pertains to preschoolers, and Trust vs. Mistrust is associated with infancy.
A client with a history of chronic back pain is prescribed oxycodone for pain management. What is the most important instruction the nurse should provide?
- A. Take the medication with food to reduce stomach upset
- B. Avoid operating heavy machinery while taking this medication
- C. Increase physical activity to enhance pain relief
- D. Report any signs of respiratory depression immediately
Correct Answer: D
Rationale: The correct answer is D: 'Report any signs of respiratory depression immediately.' Respiratory depression is a severe side effect of opioids like oxycodone and can be life-threatening. It is crucial for the nurse to instruct the client to report any signs such as slow or shallow breathing, difficulty breathing, or confusion. Choice A is incorrect as taking oxycodone with or without food does not significantly affect its efficacy. Choice B is incorrect because avoiding driving is important due to the potential impairment caused by oxycodone, but reporting respiratory depression is more critical. Choice C is incorrect as increasing physical activity may not always be suitable for individuals with chronic back pain and is not directly related to preventing respiratory depression.
The nurse is providing discharge instructions to a client with a diagnosis of peptic ulcer disease (PUD). Which dietary recommendation is most appropriate?
- A. Increase fiber intake.
- B. Avoid spicy foods.
- C. Avoid dairy products.
- D. Consume a high-fat diet.
Correct Answer: B
Rationale: The most appropriate dietary recommendation for a client with peptic ulcer disease (PUD) is to avoid spicy foods. Spicy foods can irritate the stomach lining and exacerbate symptoms of PUD. Increasing fiber intake may be beneficial for other gastrointestinal conditions but is not the primary concern for PUD. Avoiding dairy products is not a general recommendation for PUD unless the individual has a specific intolerance. Consuming a high-fat diet can increase the risk of exacerbating PUD symptoms due to the delayed gastric emptying associated with high-fat meals.
The nurse is caring for a client with cirrhosis of the liver. Which clinical finding is most concerning?
- A. Jaundice.
- B. Ascites.
- C. Spider angiomas.
- D. Asterixis.
Correct Answer: D
Rationale: The correct answer is D, Asterixis. Asterixis, also known as liver flap, is a sign of hepatic encephalopathy, a severe complication of liver disease that necessitates immediate attention. While jaundice (choice A), ascites (choice B), and spider angiomas (choice C) are common clinical findings in cirrhosis, asterixis is the most concerning due to its association with hepatic encephalopathy, which can lead to altered mental status and even coma. Jaundice, ascites, and spider angiomas are also important signs in cirrhosis, but asterixis indicates a more critical condition requiring urgent intervention.
A client is admitted with a diagnosis of diabetic ketoacidosis (DKA). Which laboratory finding is most indicative of this condition?
- A. Serum glucose of 180 mg/dL
- B. Blood pH of 7.30
- C. Positive urine ketones
- D. Serum bicarbonate of 25 mEq/L
Correct Answer: C
Rationale: The correct answer is C: Positive urine ketones. In diabetic ketoacidosis (DKA), the body breaks down fat for energy due to a lack of insulin, leading to ketone production. Positive urine ketones are a hallmark laboratory finding in DKA as they directly reflect the presence of ketosis. Choice A, serum glucose of 180 mg/dL, may be elevated in DKA, but it is not specific to this condition. Choice B, blood pH of 7.30, often shows acidosis in DKA, but urine ketones are more specific to the presence of ketosis. Choice D, serum bicarbonate of 25 mEq/L, would typically be low in DKA due to acidosis rather than elevated.