Nokea
A client with a history of chronic kidney disease (CKD) is being discharged with a prescription for epoetin alfa (Epogen). What should the nurse include in the discharge teaching?
- A. Take this medication on an empty stomach.
- B. Monitor your blood pressure regularly.
- C. Expect to feel better immediately.
- D. Avoid foods high in potassium.
Correct Answer: B
Rationale: The correct answer is B: 'Monitor your blood pressure regularly.' Epoetin alfa (Epogen) can lead to hypertension as a side effect, so it is essential for clients with CKD to monitor their blood pressure regularly. Choice A is incorrect because epoetin alfa does not need to be taken on an empty stomach. Choice C is incorrect because the client should not expect immediate improvement upon starting the medication. Choice D is incorrect because while monitoring potassium intake is important in CKD, the question specifically pertains to epoetin alfa and its side effects, not potassium intake.
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The nurse observes a client with new-onset tachycardia. What should the nurse do first?
- A. Check for the client's temperature
- B. Administer prescribed beta-blockers
- C. Assess for any chest pain or discomfort
- D. Monitor the client's blood pressure
Correct Answer: C
Rationale: When a client presents with new-onset tachycardia, the first action the nurse should take is to assess for any associated symptoms like chest pain or discomfort. This is important to differentiate the potential causes of tachycardia and guide appropriate interventions. Checking the client's temperature (Choice A) may be relevant in certain situations but is not the priority when tachycardia is observed. Administering prescribed beta-blockers (Choice B) should only be done after a comprehensive assessment and healthcare provider's orders. Monitoring the client's blood pressure (Choice D) is important, but assessing for chest pain or discomfort takes precedence in this scenario to rule out cardiac causes of tachycardia.
During a bed bath, the nurse observes that a client's IV site is red and swollen. What should the nurse do first?
- A. Discontinue the IV under physician's guidance
- B. Apply a warm compress to the site
- C. Notify the physician
- D. Document the appearance of the site and continue the bath
Correct Answer: C
Rationale: The correct first action when a nurse observes a red and swollen IV site during a bed bath is to notify the physician. This is crucial because prompt reporting allows for immediate intervention to prevent further complications. Discontinuing the IV (Choice A) should only be done under the physician's guidance to avoid any adverse effects and ensure proper care. Applying a warm compress (Choice B) may not address the underlying issue and could potentially worsen the situation if the cause is an infection or infiltration. Documenting the site's appearance and continuing the bath (Choice D) without immediate action might delay necessary treatment, leading to potential complications.
A client with chronic kidney disease is receiving hemodialysis. Which assessment finding should the nurse report to the healthcare provider immediately?
- A. Decreased urine output
- B. Weight loss of 1 kg
- C. Blood pressure of 150/90 mm Hg
- D. Presence of a bruit over the fistula
Correct Answer: C
Rationale: The correct answer is C. An elevated blood pressure in clients with chronic kidney disease undergoing hemodialysis can indicate fluid overload or poor dialysis efficacy and should be reported immediately. This finding could lead to complications such as heart failure or pulmonary edema. Choices A, B, and D are not as critical in this situation. Decreased urine output may be expected due to the kidney disease, a weight loss of 1 kg is within an acceptable range, and the presence of a bruit over the fistula is a common finding in clients undergoing hemodialysis and does not require immediate reporting.
A client is diagnosed with type 1 diabetes mellitus. Which instruction about insulin administration should the nurse emphasize?
- A. Rotate injection sites to prevent tissue damage
- B. Inject insulin into the same site to increase absorption
- C. Only use insulin pens
- D. Mix different types of insulin in the same syringe
Correct Answer: C
Rationale: The correct answer is to only use insulin pens. This is because insulin pens provide a convenient and accurate way to administer insulin. Rotating injection sites is important to prevent tissue damage and promote consistent insulin absorption, making choice A incorrect. Injecting insulin into the same site can lead to lipodystrophy and is not recommended, making choice B incorrect. Mixing different types of insulin in the same syringe can alter their action profiles and is generally not recommended, making choice D incorrect.
A client with a severe headache is being assessed by a nurse. What should the nurse do first?
- A. Administer pain relief medication
- B. Check the client's blood pressure
- C. Assess for associated symptoms such as nausea or photophobia
- D. Offer a quiet environment
Correct Answer: B
Rationale: When a client presents with a severe headache, the initial action should be to check their blood pressure. This step is crucial as it can help determine if the headache is related to hypertension or other cardiovascular issues. Administering pain relief medication should only be done after assessing the client's vital signs and confirming the cause of the headache. While assessing for associated symptoms like nausea or photophobia is important for a comprehensive evaluation, it should follow checking the blood pressure to address immediate concerns. Offering a quiet environment is indeed beneficial for the client's comfort, but it is not the priority when dealing with a severe headache.