Nokea
A client with a history of chronic kidney disease is admitted with edema. The nurse should monitor the client for which of the following electrolyte imbalances? Select all that apply.
- A. Hyperkalemia.
- B. Hyponatremia.
- C. Hypocalcemia.
- D. Hypermagnesemia.
- E. Hypophosphatemia.
Correct Answer: A, B, C, D
Rationale: Chronic kidney disease can cause hyperkalemia, hyponatremia, hypocalcemia, and hypermagnesemia due to impaired excretion and filtration.
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A 3-year-old is admitted with croup. Which intervention should the nurse prioritize?
- A. Administer racemic epinephrine
- B. Provide a high-calorie diet
- C. Encourage oral fluids
- D. Apply a warm compress to the throat
Correct Answer: A
Rationale: Racemic epinephrine is the priority for croup to reduce airway swelling and relieve stridor, addressing the immediate respiratory distress.
A client with a history of osteoporosis is prescribed alendronate (Fosamax). The nurse should instruct the client to:
- A. Take it with meals
- B. Remain upright for 30 minutes after taking
- C. Take it at bedtime
- D. Crush the tablet for easier swallowing
Correct Answer: B
Rationale: Remaining upright for 30 minutes after taking alendronate prevents esophageal irritation and enhances absorption.
A client with schizophrenia is responding well to risperidone (Risperdal) and is no longer psychotic. After teaching the client about managing his illness, which of the following statements reflects a need for further education?
- A. I just don't know if I can afford to keep taking medicines every day
- B. When my thoughts start racing, I know I need to relax more
- C. I can name the side effects of Risperdal, but I'm not having any
- D. I don't listen to my mom's religious beliefs about not using medicines
Correct Answer: A
Rationale: Concern about affording daily medication suggests a need for further education on resources or adherence strategies, as non-adherence risks relapse. Other statements reflect appropriate understanding.
The nurse is monitoring a client who is receiving a blood transfusion when the client reports diaphoresis, warmth, and a backache. The nurse should take which actions? Select all that apply.
- A. Remove the IV catheter.
- B. Document the occurrence.
- C. Stop the blood transfusion.
- D. Contact the primary health care provider.
- E. Hang 0.9% sodium chloride solution.
Correct Answer: B,C,D,E
Rationale: If a client experiences diaphoresis, warmth, and a backache, a transfusion reaction is suspected. The nurse stops the transfusion and prevents the infusion of any additional blood; then the nurse hangs a bag of 0.9% sodium chloride solution. This maintains IV access and helps maintain the client's intravascular volume. The primary health care provider is notified, as is the blood bank. The nurse also documents the occurrence, the actions taken, and the client's response. To preserve the IV access, the nurse should not remove the catheter and discontinue the IV site.
A client with a history of chronic obstructive pulmonary disease (COPD) is admitted with pneumonia. The nurse should monitor the client for which of the following complications?
- A. Hypercapnia.
- B. Hypotension.
- C. Pulmonary edema.
- D. Metabolic alkalosis.
Correct Answer: A
Rationale: Clients with COPD are at risk for hypercapnia (elevated CO2 levels) during pneumonia due to impaired gas exchange, which can worsen respiratory distress.