Nokea
A client with Herpes Zoster (shingles) on the thorax tells the nurse about having difficulty sleeping. What is the probable cause of this problem?
- A. Frequent cough
- B. Pain
- C. Nocturia
- D. Dyspnea
Correct Answer: B
Rationale: The correct answer is B: Pain. Pain is a common and significant symptom of Herpes Zoster (shingles) that can result in difficulty sleeping. The pain associated with shingles can be intense and persistent, making it challenging for the client to find a comfortable position to sleep. Nocturia (choice C), which is excessive urination during the night, is not directly related to difficulty sleeping in this context. While both frequent cough (choice A) and dyspnea (choice D) can cause sleep disturbances, in a client with Herpes Zoster on the thorax, pain is the most probable cause of sleep difficulty.
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Which of the following is a common complication of immobility?
- A. Muscle hypertrophy.
- B. Pressure ulcers.
- C. Bone fractures.
- D. Joint stiffness.
Correct Answer: B
Rationale: The correct answer is B, Pressure ulcers. Immobility can lead to pressure ulcers due to prolonged pressure on the skin, especially over bony prominences. Muscle hypertrophy (Choice A) is not a common complication of immobility; instead, muscle atrophy is more likely to occur due to disuse. Bone fractures (Choice C) can result from trauma but are not directly associated with immobility unless there is a fall or accident. Joint stiffness (Choice D) can develop due to lack of movement but is not as common or severe as pressure ulcers in cases of prolonged immobility.
A client with chronic renal failure is receiving calcium acetate (PhosLo). The nurse should monitor the client for which of the following side effects?
- A. Hypercalcemia.
- B. Hypocalcemia.
- C. Hyperglycemia.
- D. Hypoglycemia.
Correct Answer: A
Rationale: Corrected Question: A client with chronic renal failure is receiving calcium acetate (PhosLo). The nurse should monitor the client for which of the following side effects?
Rationale: The correct answer is A, Hypercalcemia. Calcium acetate (PhosLo) is a medication used to lower phosphate levels in patients with chronic renal failure. It works by binding with dietary phosphate and preventing its absorption. However, this can lead to an excess of calcium in the blood, causing hypercalcemia. Therefore, the nurse should closely monitor the client for signs and symptoms of elevated calcium levels, such as nausea, vomiting, confusion, and muscle weakness. Choices B, C, and D are incorrect as calcium acetate does not typically cause hypocalcemia, hyperglycemia, or hypoglycemia.
The client with peripheral artery disease has been prescribed clopidogrel (Plavix). The nurse understands that more teaching is necessary when the client states which of the following?
- A. I should not be surprised if I bruise more easily or if my gums bleed a little when brushing my teeth.
- B. It is important to take this medicine with food to enhance its effectiveness and minimize stomach upset.
- C. I should stop taking Plavix if it makes me feel weak and dizzy.
- D. The doctor prescribed this medicine to make my platelets less likely to stick together and help prevent clots from forming.
Correct Answer: C
Rationale: The correct answer is C. Weakness, dizziness, and headache are common adverse effects of Plavix and should be reported. It is essential to consult a physician before stopping Plavix as it plays a crucial role in preventing platelets from sticking together and forming clots. Choices A, B, and D are incorrect. Choice A is a common side effect of Plavix and does not indicate a need for further teaching. Choice B is incorrect because taking Plavix with or without food can affect its absorption and effectiveness. Choice D correctly explains the purpose of prescribing Plavix to prevent clot formation.
The client has been receiving peritoneal dialysis. The nurse should assess the client for which of the following complications that is most likely to occur?
- A. Electrolyte imbalance
- B. Peritonitis
- C. Infection
- D. Hyperglycemia
Correct Answer: B
Rationale: Peritonitis is the most likely complication to occur in clients receiving peritoneal dialysis due to the risk of infection. Peritonitis is a serious inflammation of the peritoneum lining the abdominal cavity, commonly caused by infection. While electrolyte imbalance and hyperglycemia are possible complications in some cases, peritonitis poses a more immediate and severe threat to the client's health. Infection is a general term that can encompass peritonitis but is not as specific as directly identifying peritonitis as the primary concern in this scenario.
A client who had a C-5 spinal cord injury 2 years ago is admitted to the emergency department with the diagnosis of autonomic dysreflexia secondary to a full bladder. Which assessment finding should the nurse expect this client to exhibit?
- A. Complaints of chest pain and shortness of breath
- B. Hypotension and venous pooling in the extremities
- C. Profuse diaphoresis and severe, pounding headache
- D. Pain and burning sensation upon urination and hematuria
Correct Answer: C
Rationale: Autonomic dysreflexia is a life-threatening condition commonly seen in clients with spinal cord injuries above the T6 level. It is characterized by a sudden onset of excessively high blood pressure due to a noxious stimulus below the level of injury, often a distended bladder. The exaggerated sympathetic response leads to vasoconstriction, resulting in symptoms such as profuse diaphoresis (sweating) and a severe, pounding headache. These symptoms are the body's attempt to lower blood pressure. Complaints of chest pain and shortness of breath (Choice A) are not typical findings in autonomic dysreflexia. Hypotension and venous pooling (Choice B) are opposite manifestations of autonomic dysreflexia, which is characterized by hypertension. Pain and burning sensation upon urination and hematuria (Choice D) are indicative of a urinary tract infection and not specific to autonomic dysreflexia.