Nokea
A client with the diagnosis of chronic kidney disease (CKD) has received dietary counseling about potassium restriction in the diet. The nurse determines that the client has learned the information correctly when the client states that he or she will do what when preparing vegetables?
- A. Eat only fresh vegetables.
- B. Boil them and discard the water.
- C. Use only salt substitutes to season.
- D. Buy frozen vegetables whenever possible.
Correct Answer: B
Rationale: The potassium content of vegetables can be reduced by boiling them and discarding the cooking water. Clients with CKD should avoid the use of salt substitutes altogether because they tend to be high in potassium content.
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The nurse is caring for a client with a history of breast cancer who is receiving chemotherapy. Which of the following laboratory values should the nurse monitor closely?
- A. White blood cell count.
- B. Blood glucose levels.
- C. Serum potassium.
- D. Hemoglobin A1c.
Correct Answer: A
Rationale: Chemotherapy can cause bone marrow suppression, requiring close monitoring of white blood cell counts for infection risk.
The nurse is preparing to administer insulin to a client with type 2 diabetes. Which site is most appropriate for subcutaneous injection?
- A. Deltoid muscle.
- B. Lower back.
- C. Abdomen.
- D. Upper thigh.
Correct Answer: C
Rationale: The abdomen provides consistent absorption for subcutaneous insulin due to its stable subcutaneous tissue and is a preferred site.
A hospitalized client fell on the floor and sustained a small laceration on her hand that required stitches. The intern will suture the client's hand at the client's bedside and asks for bupivacaine (Marcaine) with epinephrine and a suture kit in order to suture the laceration. The nurse should question which of the following?
- A. The intern's ability to suture.
- B. The client's room as an aseptic environment.
- C. Marcaine with epinephrine as the local anesthetic.
- D. The cosmetic effect from not having a plastic surgeon do the suturing.
Correct Answer: C
Rationale: Bupivacaine with epinephrine should be questioned for hand lacerations, as epinephrine can cause vasoconstriction and potential tissue ischemia in extremities.
Thirty minutes after a Sengstaken-Blakemore tube is inserted, the nurse observes that the client appears to be having difficulty breathing. The nurse's first action should be to:
- A. Remove the tube.
- B. Deflate the esophageal portion of the tube.
- C. Determine whether the tube is obstructing the airway.
- D. Increase the oxygen flow rate.
Correct Answer: C
Rationale: Difficulty breathing may indicate airway obstruction by the Sengstaken-Blakemore tube, so assessing this is the priority action.
The nurse is talking with a client who was diagnosed with bulimia 3 months ago. The client needs more education about the illness if she makes which of the following comments? Select all that apply.
- A. I know that this illness is chronic and intermittent. I'll always have to control it
- B. If I start severely restricting my eating, I may be building up to a bingeing episode
- C. When I'm not bingeing and purging, I can skip that Eating Disorder support group
- D. I've made a real effort to be more social and involved in activities
- E. My depression is gone so I don't need my antidepressant any longer
Correct Answer: C,E
Rationale: Skipping support groups during non-bingeing periods and stopping antidepressants due to improved mood indicate a need for further education, as bulimia requires ongoing support and medication adherence. Other statements reflect accurate understanding.