Nokea
A client with a history of chronic kidney disease is prescribed sevelamer (Renagel). The nurse should explain that this medication works by:
- A. Reducing blood pressure.
- B. Binding phosphate in the gut.
- C. Increasing urine output.
- D. Decreasing blood glucose.
Correct Answer: B
Rationale: Sevelamer binds phosphate in the gut, reducing serum phosphate levels in chronic kidney disease.
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The nurse is performing routine tracheostomy care. Which of the following steps would be appropriate for the nurse to include in the performance of the procedure?
- A. Remove the inner cannula every 2 hours for cleaning.
- B. Secure the tracheostomy ties with a square knot.
- C. Use cut gauze under the neck plate to protect the skin.
- D. Suction the inner cannula on completion of the procedure.
Correct Answer: B
Rationale: Securing tracheostomy ties with a square knot ensures stability and safety. Frequent cannula removal is unnecessary, cut gauze may fray, and suctioning is done as needed, not routinely.
You are a home health nurse caring for an elderly client in their home. They have children and grandchildren but they live far from the client and they typically visit with your clients once to two times a year. The elderly man is beginning to show some of the signs of Alzheimer's disease dementia. The wife is also 88 years of age and has had a stroke which has left her with left sided weakness, but she is willing to help her husband and to maintain his safety. What kind of support should you give the wife in terms of her role caring for her husband?
- A. You should advise the couple to move closer to their children so that they can care for their father.
- B. You should teach the wife about this progressive disease and the need to promote as much independence as possible.
- C. You should teach the wife about this progressive disease and the need to do all that she can for the husband to avoid his depression and frustration.
- D. You should advise the couple to decrease their social activities in order to preserve the husband's dignity and self-esteem.
Correct Answer: B
Rationale: Educating the wife about Alzheimer's disease and promoting the husband's independence as much as possible supports safety and dignity while respecting her role as a caregiver with physical limitations.
The nurse is caring for a client with bipolar disorder in a manic phase. Which intervention is most appropriate?
- A. Encourage group activities.
- B. Provide a quiet environment.
- C. Allow unlimited phone calls.
- D. Offer high-calorie snacks.
Correct Answer: B
Rationale: A quiet environment reduces stimuli, helping to calm a client in a manic phase.
You are caring for a group of elderly clients, many of whom are affected with multiple chronic disorders and are also, at times, affected with some acute disorders that require medical and nursing attention. As you are caring for these clients some will need a new medication regimen for an acute disorder. You should consider that fact that the elderly population is at risk for more side effects, adverse drug reactions, and toxicity and over dosages of medications because the elderly have a (n):
- A. Increased creatinine clearance.
- B. Impaired immune system.
- C. Decreased hepatic metabolism.
- D. Increased bodily fat.
Correct Answer: C
Rationale: Elderly individuals often have decreased hepatic metabolism due to reduced liver function, which affects drug metabolism and increases the risk of side effects, adverse reactions, and toxicity.
A client with a history of chronic kidney disease is prescribed sodium polystyrene sulfonate (Kayexalate). The nurse should explain that this medication works by:
- A. Reducing blood pressure.
- B. Binding potassium in the gut.
- C. Increasing urine output.
- D. Decreasing blood glucose.
Correct Answer: B
Rationale: Sodium polystyrene sulfonate binds potassium in the gut, reducing serum potassium levels in chronic kidney disease.