Nokea
A client with chronic kidney disease is admitted with complaints of fatigue and swelling in the lower extremities. What laboratory finding is most important for the nurse to report?
- A. Serum creatinine level of 2.0 mg/dL.
- B. Hemoglobin level of 8 g/dL.
- C. Potassium level of 5.6 mEq/L.
- D. Blood urea nitrogen (BUN) level of 25 mg/dL.
Correct Answer: B
Rationale: The correct answer is B. A hemoglobin level of 8 g/dL suggests anemia, which commonly occurs in clients with chronic kidney disease and requires prompt intervention. Reporting this finding is crucial to address the anemic condition. Choices A, C, and D are important in the context of chronic kidney disease but do not directly relate to the symptoms of fatigue and swelling in the lower extremities described in the scenario.
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A client has been given a prescription for tetracycline HCL (Sumycin). The nurse should emphasize the client to
- A. Take the medication with food or milk
- B. Avoid prolonged sun exposure
- C. Monitor for signs of yellowing skin or eyes
- D. Expect a yellow-brown discoloration of the teeth
Correct Answer: C
Rationale: The correct answer is C: 'Monitor for signs of yellowing skin or eyes.' Tetracycline can cause hepatotoxicity, leading to jaundice which may present as yellowing of the skin or eyes. This is a serious side effect that the nurse should emphasize to the client. Choice A is incorrect because tetracycline should generally be taken on an empty stomach, not with food or milk. Choice B is also incorrect as tetracycline can cause photosensitivity, but it is not directly related to yellowing skin or eyes. Choice D is incorrect because tetracycline can cause yellow-brown discoloration of the teeth, but this is usually seen in children under 8 years of age, not a common concern for adult clients.
A mother reports that she has been applying triple antibiotic ointment for her son's athlete's foot for two days with no improvement. What should the nurse instruct?
- A. Continue using the ointment and keep the area clean.
- B. Stop using the ointment and encourage the feet to be dried completely.
- C. Apply a different antifungal medication instead.
- D. Reapply the ointment twice a day for a longer period.
Correct Answer: B
Rationale: Antibiotic ointment is ineffective against athlete's foot, which is a fungal infection. The nurse should instruct the mother to stop using the ointment and ensure the feet are dried properly, as moisture exacerbates fungal infections. Applying a different antifungal medication is a valid option, but addressing the moisture issue by drying the feet completely is the immediate priority. Continuing to use the antibiotic ointment or reapplying it for a longer period will not treat the fungal infection effectively.
A client with adrenal crisis has a temperature of 102°F, heart rate of 138 bpm, and blood pressure of 80/60 mmHg. Which action should the nurse implement first?
- A. Obtain an analgesic prescription.
- B. Infuse intravenous fluid bolus.
- C. Administer PRN oral antipyretic.
- D. Cover the client with a cooling blanket.
Correct Answer: B
Rationale: In a client with adrenal crisis presenting with a high temperature, tachycardia, and hypotension, the priority action for the nurse to implement first is to infuse an intravenous fluid bolus. This intervention aims to address the hypotension by increasing the circulating volume and improving perfusion. Obtaining an analgesic prescription (Choice A) is not the priority in this situation. Administering an oral antipyretic (Choice C) may help reduce the fever but does not address the primary issue of hypotension. Covering the client with a cooling blanket (Choice D) may help with temperature control but does not address the hemodynamic instability caused by the adrenal crisis.
The nurse is assessing a client with a new diagnosis of hyperthyroidism. Which assessment finding should the nurse expect?
- A. Decreased heart rate
- B. Increased appetite
- C. Cold intolerance
- D. Weight gain
Correct Answer: B
Rationale: In hyperthyroidism, there is an increase in metabolism, leading to symptoms such as increased appetite, weight loss, and heat intolerance. Therefore, the nurse should expect an increased appetite in a client with hyperthyroidism. Choices A, C, and D are incorrect because decreased heart rate and cold intolerance are more commonly associated with hypothyroidism, while weight gain is not typically seen in hyperthyroidism.
A client who had a subtotal parathyroidectomy two days ago is now preparing for discharge. Which assessment finding requires immediate provider notification?
- A. Afebrile with a normal pulse.
- B. No bowel movement since surgery.
- C. No appetite for breakfast.
- D. A positive Chvostek's sign.
Correct Answer: D
Rationale: A positive Chvostek's sign suggests hypocalcemia, which is a post-parathyroidectomy complication and requires prompt treatment. The other options are less urgent: being afebrile with a normal pulse is expected, no bowel movement since surgery can be managed with interventions like early ambulation and stool softeners, and no appetite for breakfast is common postoperatively and can be addressed without immediate provider notification.