Nokea
A nurse cares for a client who is diagnosed with acute rejection 2 months after receiving a simultaneous pancreas-kidney transplant. The client states, 'I was doing so well with my new organs, and the thought of having to go back to living on hemodialysis and taking insulin is so depressing.' How should the nurse respond?
- A. Following-Drug regimen more closely would have prevented this.
- B. One acute rejection episode does not mean that you will lose the new organs.
- C. Dialysis is a viable treatment option for you and may save your life.
- D. Since you are on the national registry, you can receive a second transplantation.
Correct Answer: B
Rationale: An acute rejection episode does not necessarily lead to organ loss, as immunosuppressive therapy can often manage it. Blaming the client, emphasizing dialysis, or discussing retransplantation is not supportive or accurate in this context.
You may also like to solve these questions
A nurse teaches a client with diabetes mellitus about sick day management. Which statement should the nurse include in this client's teaching?
- A. When ill, avoid eating or drinking to reduce vomiting and diarrhea.
- B. Monitor your blood glucose levels at least every 4 hours while sick.
- C. If vomiting, do not use insulin or take your oral antidiabetic agent.
- D. Continue your prescribed exercise regimen even if you are sick.
Correct Answer: B
Rationale: Monitoring blood glucose every 4 hours during illness helps manage fluctuations. Continuing medications, eating as tolerated, and avoiding exercise during illness are also recommended, making the other options incorrect.
After teaching a young adult client who is newly diagnosed with type 1 diabetes mellitus, the nurse assesses the client's understanding. Which statement made by the client indicates a correct understanding of the need for eye examinations?
- A. At my age, I should continue seeing the ophthalmologist as I usually do.
- B. I will see the eye doctor when I have a vision problem and yearly after age 40.
- C. My vision will change quickly, I should see the ophthalmologist twice a year.
- D. Diabetes can cause blindness, so I should see the ophthalmologist yearly.
Correct Answer: D
Rationale: Diabetic retinopathy is a leading cause of blindness in North America. All clients with diabetes, regardless of age, should be examined by an ophthalmologist at diagnosis and at least yearly thereafter to monitor for retinopathy.
After teaching a client who has diabetes mellitus and proliferative retinopathy, nephropathy, and peripheral neuropathy, the nurse assesses the client's understanding. Which statement made by the client indicates a correct understanding of the teaching?
- A. I have so many complications, exercising is not recommended.
- B. I will exercise more frequently because I have so many complications.
- C. I used to run for exercise; I will start training for a marathon.
- D. I should look into swimming or water aerobics to get my exercise.
Correct Answer: D
Rationale: Swimming or water aerobics is a suitable exercise for clients with diabetic complications, as it minimizes foot injury risk. Vigorous exercise like marathon running or avoiding exercise altogether is not recommended.
A nurse teaches a client about self-monitoring of blood glucose levels. Which statement should the nurse include in this client's teaching to prevent bloodborne infections?
- A. Wash your hands after completing each test.
- B. Do not share your monitoring equipment.
- C. Wipe excess blood from the strip with a cotton ball.
- D. Use gloves when monitoring your blood glucose.
Correct Answer: B
Rationale: Sharing monitoring equipment can transmit bloodborne infections like hepatitis B, which can survive in dried blood. Not sharing equipment is critical. Washing hands before testing, not after, is recommended. Wiping blood with a cotton ball or using gloves is not standard practice for preventing infections.
A nurse cares for a client who is prescribed pioglitazone (Actos). After 6 months of therapy, the client reports that his urine has become darker since starting the medication. Which action should the nurse take?
- A. Assess for pain or burning with urination.
- B. Review the client's liver function study results.
- C. Instruct the client to increase water intake.
- D. Test a sample of urine for occult blood.
Correct Answer: B
Rationale: Thiazolidinediones like pioglitazone can affect liver function. Dark urine may indicate liver impairment due to increased bilirubin. Reviewing liver function studies is the priority. Assessing for urinary symptoms, increasing water intake, or testing for occult blood are not directly related to this issue.