Nokea
A client with a history of chronic kidney disease is prescribed calcitriol (Rocaltrol). The nurse should instruct the client to:
- A. Monitor for signs of hypercalcemia.
- B. Take the medication on an empty stomach.
- C. Avoid phosphorus-rich foods.
- D. Stop the medication if nausea occurs.
Correct Answer: A
Rationale: Calcitriol can cause hypercalcemia, requiring monitoring for symptoms like confusion.
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A 56-year-old woman is admitted for a modified radical mastectomy. The client appears anxious and asks many questions. The nurse's best course of action is to:
- A. Tell the client as much as she wants to know and is able to understand.
- B. Delay discussing the client's questions with her until the convalescent phase of her care.
- C. Delay discussing the client's questions with her until her apprehension subsides.
- D. Explain to the client that she should discuss her questions with her physician.
Correct Answer: A
Rationale: Addressing the client's questions thoroughly and at her level of understanding reduces anxiety and supports informed consent.
The nurse instructs the client who is taking gentamicin to monitor factors related to renal function. The nurse determines that the client needs additional instruction when he makes which of the following statements?
- A. I should call you if I notice that I'm not urinating as much.'
- B. I should call you if my urine looks dark or unusual.'
- C. I should call you if my legs swell or I notice my skin looks puffy around my eyes.'
- D. I should call you if I have a fever.'
Correct Answer: D
Rationale: Gentamicin can cause nephrotoxicity, so monitoring for decreased urine output, dark urine, or edema (swelling) is appropriate. Fever is not directly related to renal function, indicating a need for further instruction.
The nurse is teaching a client with a new diagnosis of rheumatoid arthritis about medication management. Which of the following medications should the client expect to take?
- A. Methotrexate.
- B. Colchicine.
- C. Allopurinol.
- D. Probenecid.
Correct Answer: A
Rationale: Methotrexate is a disease-modifying antirheumatic drug (DMARD) commonly used for rheumatoid arthritis.
Your 87 year old client has a history of heart disease and fibromyalgia. This client has an internal pacemaker and is also a diabetic client. During your annual visit with this client, the client tells you that they would like to begin some alternative and homeopathic health care practices. What should you include in your teaching plan for this client?
- A. Information about the lack of scientific evidence regarding the effectiveness of all herbs.
- B. Data to support the fact that magnets can be effective in terms of fibromyalgia pain, and as such, may be a good choice for this client.
- C. Research that suggests that prayer is an effective alternative method to relieve pain and stress that can be helpful to this client.
- D. Information that contraindicates the use of biofeedback because this alternative, complementary health practice can interfere with the client's pacemaker functioning.
Correct Answer: C
Rationale: Prayer is a safe and evidence-supported complementary practice that can help reduce stress and pain, suitable for this client. There is insufficient evidence for magnets in fibromyalgia treatment, and biofeedback is not contraindicated for pacemakers. Not all herbs lack scientific evidence, so option A is overly broad.
The nurse is caring for a young adult client diagnosed with sarcoidosis. The client is angry and tells the nurse that there is no point in learning disease management because there is no possibility of ever being cured. Based on the client's statement, the nurse determines that the client is experiencing which potential problem?
- A. Apprehension
- B. Powerlessness
- C. Intellectualization
- D. Ineffective thought process
Correct Answer: B
Rationale: The client with powerlessness expresses feelings of having no control over a situation or outcome. Apprehension is fearful or uneasy anticipation of something. Intellectualization is excessive reasoning to avoid feeling. Ineffective thought process involves interruption in normal thought.