Nokea
A client with a history of hypertension is prescribed hydrochlorothiazide (HCTZ). The nurse should monitor the client for which of the following electrolyte imbalances?
- A. Hypokalemia.
- B. Hypernatremia.
- C. Hypermagnesemia.
- D. Hypercalcemia.
Correct Answer: A
Rationale: Hydrochlorothiazide, a thiazide diuretic, can cause hypokalemia due to potassium loss.
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A client with a diagnosis of gastroesophageal reflux disease (GERD) has just received a breakfast tray. The nurse notices that which is the only food that will increase the lower esophageal sphincter (LES) pressure and thus lessen the client's symptoms?
- A. Coffee
- B. Nonfat milk
- C. Fresh scrambled eggs
- D. Whole wheat toast with butter
Correct Answer: B
Rationale: Foods that increase the LES pressure will decrease reflux and lessen the symptoms of GERD. The food substance that will increase the LES pressure is nonfat milk. The other substances listed decrease the LES pressure, thus increasing reflux symptoms. Aggravating substances include chocolate, coffee, fatty foods, and alcohol and should be avoided in the diet of a client with GERD.
A nurse is assessing an 82-year-old for depression, because of the client's age, the nurses' assessment should be guided by the fact that:
- A. Sadness of mood is usually present but it is masked by other symptoms.
- B. Impairment of cognition usually is not present.
- C. Psychosomatic tendencies do not tend to dominate.
- D. Antidepressant therapies are less effective in older adults.
Correct Answer: A
Rationale: In older adults, depression may present with atypical symptoms, such as somatic complaints or irritability, rather than overt sadness, which can mask the condition.
A client with a history of chronic obstructive pulmonary disease (COPD) is prescribed ipratropium (Atrovent). The nurse should instruct the client to:
- A. Rinse the mouth after inhalation.
- B. Take the medication with meals.
- C. Avoid using the inhaler during an acute attack.
- D. Stop the medication if dizziness occurs.
Correct Answer: A
Rationale: Rinsing the mouth after ipratropium inhalation prevents oral irritation or infection.
A woman is taking oral contraceptives. The nurse teaches the client to report which of the following danger signs?
- A. Breakthrough bleeding
- B. Severe calf pain
- C. Mild headache
- D. Weight gain of 3 lb
Correct Answer: B
Rationale: Severe calf pain may indicate a deep vein thrombosis, a serious complication of oral contraceptives that requires immediate reporting. Breakthrough bleeding, mild headaches, and minor weight gain are less urgent.
The nurse is caring for a client with a history of burns. Which of the following interventions should be included in the plan of care? Select all that apply.
- A. Monitor urine output.
- B. Administer tetanus prophylaxis.
- C. Provide psychological support.
- D. Restrict visitors to prevent infection.
- E. Apply cold compresses to burns.
Correct Answer: A, B, C
Rationale: Monitoring urine output, tetanus prophylaxis, and psychological support are essential. Visitors should be screened, not restricted, and cold compresses are contraindicated.