Nokea
A client with a history of renal calculi formation is being discharged after surgery to remove the calculus. What instructions should the nurse include in the client's discharge teaching plan?
- A. Increase daily fluid intake to at least 2 to 3 L.
- B. Strain urine at home regularly.
- C. Eliminate dairy products from the diet.
- D. Follow measures to alkalinize the urine.
Correct Answer: A,B
Rationale: High fluid intake (2-3 L) prevents stone recurrence, and straining urine monitors for stone passage. Dairy restriction or urine alkalinization depends on stone type.
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A client is receiving an I.V. infusion of 5% dextrose in water (D5W). The skin around the I.V. insertion site is red, warm to touch, and painful. The nurse should first:
- A. Administer acetaminophen (Tylenol)
- B. Change the D5W to normal saline
- C. Discontinue the I.V.
- D. Place a warm compress on the area
Correct Answer: C
Rationale: Redness, warmth, and pain at the I.V. site indicate phlebitis or infiltration. The first action is to discontinue the I.V. to prevent further tissue damage. Changing fluids, applying a compress, or giving acetaminophen does not address the immediate issue.
The nurse should expect single-donor platelets to be ordered for which of the following clients?
- A. A client who is receiving multiple platelet transfusions.
- B. A client who is deficient in coagulation factors.
- C. A client whose platelet count is greater than 50,000/mm³.
- D. A client who is refractory to random-donor platelets.
Correct Answer: D
Rationale: Single-donor platelets are used for clients refractory to random-donor platelets to reduce the risk of alloimmunization and improve transfusion efficacy.
During preadmission testing for same-day surgery, a client states that she has added two cloves of garlic each day to her diet to help control her blood pressure. The nurse should further inquire about which of the following?
- A. The type of surgery the client is having.
- B. What her blood pressure has been running.
- C. The amount of garlic she is eating.
- D. Her preference for the type of anesthesia.
Correct Answer: B
Rationale: Garlic can affect blood pressure and has anticoagulant properties, which may increase bleeding risk during surgery. Inquiring about the client's blood pressure helps assess the impact of garlic on her condition and informs surgical planning. The type of surgery, amount of garlic, or anesthesia preference are less directly relevant to this concern.
Which action is contraindicated for a client with a risk of increased ICP?
- A. Elevate head of bed.
- B. Administer mannitol.
- C. Encourage coughing.
- D. Monitor neurological status.
Correct Answer: C
Rationale: Coughing is contraindicated as it increases intracranial pressure.
The nurse is checking the laboratory results of a 52-year-old client with colon cancer admitted for further chemotherapy. The client has lost 30 lb (13.6 kg) since initiation of the treatment. Which laboratory result should be reported to the health care provider?
- A. Blood glucose level of 95 mg/dL.
- B. Total cholesterol level of 102 mg/dL.
- C. Hemoglobin level of 12.3 mg/dL.
- D. Albumin level of 2.8 g/dL.
Correct Answer: D
Rationale: A low albumin level (2.8 g/dL) indicates malnutrition, which is concerning given the client's significant weight loss and needs to be reported for nutritional intervention.