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A client with chronic renal failure is receiving epoetin alfa (Epogen) to treat anemia. The nurse should assess the client for which of the following side effects?
- A. Hypertension.
- B. Hypotension.
- C. Infection.
- D. Edema.
Correct Answer: A
Rationale: The correct answer is A: Hypertension. Epoetin alfa (Epogen) is a medication used to treat anemia in clients with chronic renal failure. One common side effect of this medication is hypertension. Epoetin alfa stimulates red blood cell production, which can lead to an increase in blood pressure. Therefore, the nurse should closely monitor the client for signs and symptoms of hypertension while on this medication. Choices B, C, and D are incorrect. Hypotension is not typically associated with epoetin alfa administration. Infection is not a direct side effect of epoetin alfa. Edema is also not a common side effect of this medication.
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An overweight client taking warfarin (Coumadin) has dry skin due to decreased arterial blood flow. What should the nurse instruct the client to do? Select all that apply.
- A. Apply lanolin or petroleum jelly to intact skin.
- B. Follow a reduced-calorie, reduced-fat diet.
- C. Inspect the involved areas daily for new ulcerations.
- D. Instruct the client to limit activities of daily living (ADLs).
Correct Answer: A
Rationale: To address dry skin and prevent chronic ulcers and infections in an overweight client on warfarin with decreased arterial blood flow, the nurse should instruct the client to apply lanolin or petroleum jelly to intact skin. This helps maintain skin integrity and moisture. Following a reduced-calorie, reduced-fat diet (Choice B) may be beneficial for weight management but is not directly related to skin care. Inspecting involved areas daily for new ulcerations (Choice C) is important for skin assessment and early intervention but does not specifically address dry skin. Instructing the client to limit activities of daily living (ADLs) (Choice D) is not necessary for addressing dry skin; in fact, promoting mobility and circulation through appropriate activities is crucial.
The healthcare professional assesses a client with petechiae and ecchymosis scattered across the arms and legs. Which laboratory results should the healthcare professional review?
- A. Red blood cell count
- B. Platelet count
- C. Hemoglobin levels
- D. White blood cell count
Correct Answer: B
Rationale: The platelet count is the most appropriate laboratory result to review in a client presenting with petechiae and ecchymosis. Petechiae and ecchymosis are indicative of potential bleeding issues, which can be caused by low platelet count or impaired platelet function. Platelets are essential for clotting, and a low platelet count can lead to bleeding disorders. Reviewing the platelet count will provide valuable information about the client's clotting ability.
Choice A, red blood cell count, is not typically associated with petechiae and ecchymosis. Hemoglobin levels (Choice C) are more related to anemia than bleeding disorders like thrombocytopenia. White blood cell count (Choice D) is not directly linked to the presence of petechiae and ecchymosis, which are more specific to platelet-related issues.
A client with diabetes is taking insulin lispro (Humalog) injections. The nurse should advise the client to eat:
- A. Within 10 to 15 minutes after the injection.
- B. 1 hour after the injection.
- C. At any time, because timing of meals with lispro injections is unnecessary.
- D. 2 hours before the injection.
Correct Answer: A
Rationale: The correct answer is to eat within 10 to 15 minutes after the injection. Insulin lispro, also known as Humalog, is a rapid-acting insulin that starts working very quickly. Eating shortly after the injection helps match the food intake with the insulin action, reducing the risk of hypoglycemia. Choice B is incorrect because waiting 1 hour after the injection may lead to a mismatch between insulin activity and food intake. Choice C is incorrect as timing meals with lispro injections is essential to optimize glycemic control. Choice D is incorrect as eating 2 hours before the injection is not in alignment with the rapid action of insulin lispro and may lead to fluctuations in blood sugar levels.
The healthcare provider is assessing a client who is receiving hemodialysis for the first time. Which of the following findings should be reported to the healthcare provider immediately?
- A. Blood pressure of 150/90 mm Hg.
- B. Nausea and vomiting.
- C. Fatigue.
- D. Headache.
Correct Answer: B
Rationale: Nausea and vomiting are critical symptoms that should be reported immediately when a client is receiving hemodialysis for the first time. These symptoms could indicate a severe complication, such as hypotension, infection, electrolyte imbalance, or other adverse reactions to the procedure. It is essential to address these symptoms promptly to prevent further complications or harm to the client. Choices A, C, and D are not immediate concerns during the first hemodialysis session and can be addressed appropriately after addressing the urgent issue of nausea and vomiting.
What is the most common symptom of gastroesophageal reflux disease (GERD)?
- A. Heartburn.
- B. Nausea.
- C. Abdominal pain.
- D. Vomiting.
Correct Answer: A
Rationale: The correct answer is A: Heartburn. Heartburn is the most common symptom of GERD as it occurs due to the reflux of stomach acid into the esophagus. This leads to a burning sensation in the chest that can worsen after eating, lying down, or bending over. Choice B, Nausea, is not typically the most common symptom of GERD, although it can occur in some cases. Choice C, Abdominal pain, is not a primary symptom of GERD and is more commonly associated with other gastrointestinal conditions. Choice D, Vomiting, is also not the most common symptom of GERD, although it can occur in severe cases or as a result of complications.