Nokea
A client with chronic renal failure is scheduled for hemodialysis in the morning. Which pre-dialysis medication should the nurse withhold until after the dialysis treatment is completed?
- A. Calcium carbonate (Os-Cal)
- B. Furosemide (Lasix)
- C. Spironolactone (Aldactone)
- D. Multivitamins
Correct Answer: B
Rationale: The correct answer is B: Furosemide (Lasix). Furosemide is a diuretic that promotes fluid loss, and giving it before hemodialysis can lead to excessive fluid loss during the treatment, potentially causing hypovolemia. Withholding furosemide until after the dialysis session helps in preventing this complication. Choices A, C, and D are incorrect because calcium carbonate, spironolactone, and multivitamins are not typically contraindicated before hemodialysis in clients with chronic renal failure.
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A graduate nursing student requests information, including laboratory findings and chest x-ray results, about all clients with symptoms of H1N1 who have been seen during the last month in a community health clinic. Which action should the charge nurse take?
- A. Ask if permission has been obtained from the research committee.
- B. Ask the student to sign a standard waiver form.
- C. Obtain written authorization from clients to release the information.
- D. Provide the information for research purposes only.
Correct Answer: C
Rationale: The correct action for the charge nurse to take is to obtain written authorization from clients to release the information. This step is crucial to ensure compliance with privacy laws and ethical standards. Asking for permission from the research committee (Choice A) may not address the individual clients' rights to privacy. Asking the student to sign a standard waiver form (Choice B) is not appropriate, as the authorization should come from the clients themselves. Providing the information for research purposes only (Choice D) without proper authorization violates client confidentiality and privacy.
A nurse has started a group for senior citizens in a church setting. The group decides that their first project will be to begin a program for home-bound members. Which program outcome is the best measure of the project's effectiveness?
- A. number of home-bound seniors who are visited
- B. number of church members who are over 65
- C. average annual income for the homebound members
- D. calls received showing interest in the program
Correct Answer: A
Rationale: The number of home-bound seniors visited is the best measure of the project's effectiveness as it directly reflects the reach and impact of the program. Choice B is incorrect as it does not directly relate to the effectiveness of the program for home-bound seniors. Choice C is irrelevant as the average annual income of home-bound members is not a direct measure of the program's effectiveness. Choice D, calls showing interest, is not as direct a measure as the actual visits to the home-bound seniors.
A public health nurse is working with a community to improve access to dental care. Which intervention is most likely to be effective?
- A. Setting up dental clinics in accessible locations
- B. Distributing flyers with information about dental services
- C. Offering transportation vouchers for dental appointments
- D. Partnering with local businesses to promote dental health
Correct Answer: A
Rationale: Setting up dental clinics in accessible locations is the most effective intervention to improve access to dental care. By having dental clinics in easily reachable places, community members are more likely to seek and utilize dental services. Distributing flyers may raise awareness, but it may not address the issue of physical accessibility to dental care. Offering transportation vouchers could help with transportation barriers but might not address the core issue of proximity to dental services. Partnering with local businesses to promote dental health is a good initiative, but it may not directly improve access to dental care as setting up clinics in accessible locations would.
During a community health fair, the nurse conducts a blood pressure screening for a 60-year-old woman who has a blood pressure of 160/100 mm Hg. What should the nurse do first?
- A. Instruct the client to monitor her blood pressure at home
- B. Refer the client to her healthcare provider for further evaluation
- C. Educate the client on lifestyle changes to reduce blood pressure
- D. Recheck the blood pressure in 15 minutes
Correct Answer: B
Rationale: When encountering a high blood pressure reading at a community health fair, it is essential for the nurse to refer the client to her healthcare provider for further evaluation. This step ensures that the client receives a comprehensive assessment, diagnosis, and appropriate management plan. In this scenario, it is crucial to prioritize professional evaluation over self-monitoring, lifestyle education, or immediate rechecking of the blood pressure. Referral to a healthcare provider allows for timely intervention and ongoing monitoring of the client's blood pressure to prevent potential complications.
A client who has active tuberculosis (TB) is admitted to the medical unit. What action is most important for the nurse to implement?
- A. Wear a gown and gloves.
- B. Have the client wear a mask.
- C. Perform hand hygiene.
- D. Assign the client to a negative air-flow room.
Correct Answer: D
Rationale: The correct answer is to assign the client to a negative air-flow room (Choice D). Active tuberculosis requires implementation of airborne precautions, including isolating the client in a negative pressure air-flow room to prevent the spread of the infection to others. Choice A (Wear a gown and gloves) is important for standard precautions but does not address the specific airborne precautions needed for tuberculosis. Choice B (Have the client wear a mask) may help reduce the spread of respiratory droplets but does not provide adequate protection for healthcare workers or other patients. Choice C (Perform hand hygiene) is essential for infection control but is not the most critical action when dealing with an airborne infection like tuberculosis.