Nokea
A client with Raynaud's phenomenon is prescribed diltiazem (Cardizem). An expected outcome is:
- A. Decreased heart rate
- B. A return to normal sinus rhythm
- C. Reduced episodes of finger numbness
- D. Increased SpO2
Correct Answer: C
Rationale: Diltiazem, a calcium channel blocker, reduces vasospasm in Raynaud's by promoting vasodilation, decreasing episodes of finger numbness. It may lower heart rate or affect rhythm, but these are not primary goals, and SpO2 is not directly improved.
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In which of the following clients is an autotransfusion contraindicated?
- A. The client who has cancer.
- B. The client who is in danger of cardiac arrest.
- C. The client with a contaminated wound.
- D. The client with a ruptured bowel.
Correct Answer: A,C,D
Rationale: Autotransfusion is contraindicated in cancer (risk of spreading malignant cells), contaminated wounds, or ruptured bowel (risk of infection or bacterial spread). It may be used cautiously in cardiac arrest if no other contraindications exist.
The nurse conducts a review course on older adults and medication elimination/excretion. It would be appropriate for the nurse to note which factor may impact drug elimination? Select all that apply.
- A. Diminished glomerular filtration
- B. Decreased hepatic enzyme functioning
- C. Decreased peristalsis
- D. Lower pH of the gastric secretions
- E. Increased acidity of the gastric secretions
- F. Low functioning nephrons
Correct Answer: A,B,F
Rationale: Diminished glomerular filtration, decreased hepatic function, and low-functioning nephrons impair drug elimination in older adults.
After pituitary surgery, the nurse should assess the client for which of the following?
- A. Urine specific gravity less than 1.010.
- B. Urine output between 1 and 2 L/day.
- C. Blood glucose level higher than 300 mg/dL.
- D. Urine negative for glucose and ketones.
Correct Answer: A
Rationale: Low urine specific gravity (<1.010) may indicate diabetes insipidus, a common complication post-pituitary surgery due to reduced vasopressin.
A priority in the first 24 hours after a bilateral adrenalectomy is:
- A. Beginning oral nutrition.
- B. Promoting self-care activities.
- C. Preventing adrenal crisis.
- D. Ambulating in the hallway.
Correct Answer: C
Rationale: Preventing adrenal crisis is critical post-adrenalectomy due to sudden loss of adrenal hormone production, requiring steroid replacement.
The client with Ménière'sdisease is instructed to modify his diet. The nurse should explain that the most frequently recommended diet modification for the client's disease is:
- A. Low sodium.
- B. High protein.
- C. Low carbohydrate.
- D. Low fat.
Correct Answer: A
Rationale: A low-sodium diet is recommended for Ménière'sdisease to reduce fluid retention in the inner ear, which can decrease the frequency and severity of vertigo attacks.