Nokea
A client with chronic obstructive pulmonary disease is bedridden at home and gets little exercise. The nurse should assess the client for which of the following?
- A. Increased sodium retention.
- B. Increased calcium excretion.
- C. Increased insulin use.
- D. Increased red blood cell production.
Correct Answer: B
Rationale: Prolonged immobility in COPD increases calcium excretion due to bone resorption, risking osteoporosis. The other options are not directly related to immobility.
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A client's laboratory test results reveal a decrease in both serum transferrin and total iron-binding capacity (TIBC). Which disorder is the most likely cause of the client's anemia?
- A. Infection
- B. Malnutrition
- C. Iron deficiency
- D. Sickle cell disease
Correct Answer: B
Rationale: Malnutrition can cause reductions in the serum transferrin and the TIBC. Infection is an unrelated option. Iron-deficiency anemia is usually characterized by decreased iron-binding capacity but increased transferrin levels. Additionally, in clinical practice, the hemoglobin level is routinely used to detect iron-deficiency anemia. Sickle cell anemia is diagnosed by determining that the client has hemoglobin S.
A client with a diagnosis of hyperthyroidism is prescribed propylthiouracil (PTU). The nurse should monitor the client for which of the following side effects?
- A. Weight gain.
- B. Agranulocytosis.
- C. Hypertension.
- D. Hyperglycemia.
Correct Answer: B
Rationale: Propylthiouracil can cause agranulocytosis, requiring monitoring of white blood cell counts.
To prevent development of peripheral neuropathies associated with isoniazid administration, the nurse should teach the client to:
- A. Avoid excessive sun exposure.
- B. Follow a low-cholesterol diet.
- C. Obtain extra rest.
- D. Supplement the diet with pyridoxine (vitamin B6).
Correct Answer: D
Rationale: Isoniazid can deplete vitamin B6, leading to neuropathy; supplementation prevents this side effect.
A client with a history of breast cancer is prescribed letrozole (Femara). The nurse should monitor the client for which of the following adverse effects?
- A. Bone loss.
- B. Hyperglycemia.
- C. Hypertension.
- D. Weight gain.
Correct Answer: A
Rationale: Letrozole, an aromatase inhibitor, can cause bone loss, increasing osteoporosis risk.
The nurse is caring for a client who has just received a diagnosis of terminal cancer. The client says, 'I don't want to tell my family yet.' Which of the following responses by the nurse is most appropriate?
- A. You should tell them soon so they can support you.'
- B. I respect your decision. Let me know how I can help you.'
- C. Your family needs to know so they can prepare.'
- D. I'll talk to your family for you if you'd like.'
Correct Answer: B
Rationale: Respecting the client's autonomy while offering support is the most appropriate response, honoring their decision about disclosure.