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A healthcare professional is reviewing the medical record of a client who is receiving furosemide. Which of the following laboratory values should the healthcare professional monitor while the client is taking this medication?
- A. Sodium
- B. Glucose
- C. Potassium
- D. Calcium
Correct Answer: C
Rationale: The correct answer is C: Potassium. Furosemide is a diuretic that can cause potassium depletion due to increased urinary excretion. Monitoring potassium levels is crucial to prevent hypokalemia, which can lead to serious complications such as cardiac arrhythmias. Sodium (choice A) levels are not typically affected by furosemide. Glucose (choice B) monitoring is important with other medications like corticosteroids but is not directly related to furosemide use. Calcium (choice D) levels are not significantly impacted by furosemide.
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What is the priority when managing a client with a chest tube postoperatively?
- A. Clamp the chest tube for 30 minutes every 4 hours
- B. Check for air leaks and proper functioning of the chest tube
- C. Encourage deep breathing and coughing every 2 hours
- D. Encourage frequent coughing to clear secretions
Correct Answer: B
Rationale: The priority when managing a client with a chest tube postoperatively is to check for air leaks and ensure the proper functioning of the chest tube. This is crucial to prevent complications such as pneumothorax or hemothorax. Clamping the chest tube intermittently can lead to a buildup of pressure in the pleural space and should not be done without a specific medical indication. Encouraging deep breathing and coughing helps with lung expansion but is not the priority over ensuring the chest tube's proper function. Encouraging frequent coughing may increase the risk of dislodging the chest tube or causing complications.
A nurse is admitting a client who has anorexia nervosa. Which of the following is an expected finding?
- A. Iron 90 mcg/dl.
- B. Prealbumin 10 mcg/dl.
- C. Serum creatinine 0.8 mg/dl.
- D. Calcium 9.5 mg/dl.
Correct Answer: B
Rationale: Corrected Rationale: Low prealbumin levels are indicative of malnutrition, which is common in individuals with anorexia nervosa. Iron levels, serum creatinine, and calcium levels are not typically affected in the same way by anorexia nervosa, making choices A, C, and D incorrect.
What are the key factors in assessing a patient's fall risk?
- A. Assess the patient's age and mobility
- B. Evaluate the patient's medication list for sedatives
- C. Assess the patient's vision and hearing
- D. Check for recent falls and cognitive impairment
Correct Answer: A
Rationale: The correct answer is A. Assessing the patient's age and mobility are key factors in determining fall risk. Age can affect balance and reaction time, while mobility influences the patient's stability. Choices B, C, and D are important considerations in assessing a patient's fall risk as well, but age and mobility play a more direct role in determining the patient's susceptibility to falls.
A nurse on a med surge unit has received change of shift report and will care for 4 clients. Which of the following clients' needs will the nurse assign to an AP?
- A. Feeding a client who was admitted 24 hours ago with aspiration pneumonia
- B. Reinforcing teaching with a client who is learning to walk with a quad cane
- C. Reapplying a condom catheter for a client who has urinary incontinence
- D. Applying a sterile dressing to a pressure ulcer
Correct Answer: C
Rationale: The correct answer is C because reapplying a condom catheter for a client with urinary incontinence is a task that can be safely assigned to an assistive personnel (AP) as it falls within their scope of practice. Choice A involves the assessment of a client with aspiration pneumonia, which requires nursing judgment. Choice B requires teaching and guidance, which is the responsibility of the nurse. Choice D involves applying a sterile dressing, which requires nursing skills and knowledge.
How can a healthcare provider prevent deep vein thrombosis (DVT) in post-operative patients?
- A. Encourage early ambulation
- B. Administer anticoagulants
- C. Apply compression stockings
- D. All of the above
Correct Answer: D
Rationale: All of the above options are essential in preventing deep vein thrombosis (DVT) in post-operative patients. Encouraging early ambulation helps prevent blood stasis in the lower extremities, reducing the risk of DVT. Administering anticoagulants can prevent blood clots from forming. Compression stockings promote blood flow, reducing the likelihood of clot formation. Each intervention plays a crucial role in DVT prevention, making the correct answer 'All of the above.' Choices A, B, and C are not exclusive of each other but rather work synergistically to provide comprehensive prevention against DVT.