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A nurse is assessing a client with a urinary tract infection who takes an antihypertensive drug. The nurse reviews the client’s urinalysis results (see chart). The nurse should:
- A. Encourage the client to increase fl uid intake.
- B. Withhold the next dose of antihypertensive medication.
- C. Restrict the client’s sodium intake.
- D. Encourage the client to eat at least half of a banana per day
Correct Answer: A
Rationale: The client’s urine specifi c gravity is elevated. Specific gravity is a refl ection of the concentrating ability of the kidneys. This level indicates that the urine is concentrated. By increasing fluid intake, the urine will become more dilute. Antihypertensives do not make urine more concentrated unless there is a diuretic component within them. The nurse should not hold a dose of antihypertensive medication. Sodium tends to pull water with it; by restricting sodium, less water, not more, will be present. Bananas do not aid in the dilution of urine.
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Which lab result indicates worsening acute renal failure?
- A. Creatinine 3.5 mg/dL.
- B. BUN 20 mg/dL.
- C. Potassium 4.0 mEq/L.
- D. Sodium 140 mEq/L.
Correct Answer: A
Rationale: Elevated creatinine indicates reduced kidney function in acute renal failure.
Which position is best for a client with a hemorrhagic stroke?
- A. Flat supine.
- B. Head elevated 30 degrees.
- C. Prone position.
- D. Trendelenburg position.
Correct Answer: B
Rationale: Head elevation at 30 degrees reduces intracranial pressure while maintaining cerebral perfusion in hemorrhagic stroke.
Which activity should the nurse encourage the client to avoid when there is a risk for increased intracranial pressure (ICP)?
- A. Deep breathing.
- B. Turning.
- C. Coughing.
- D. Passive range-of-motion (ROM) exercises.
Correct Answer: C
Rationale: Coughing increases intrathoracic pressure, which can elevate ICP. Deep breathing, turning, and passive ROM are generally safe and may even help prevent complications like atelectasis or contractures if done gently.
Which of the following is a priority goal for the client with chronic obstructive pulmonary disease (COPD)?
- A. Maintaining functional ability.
- B. Minimizing chest pain.
- C. Increasing carbon dioxide levels in the blood.
- D. Treating infectious agents.
Correct Answer: A
Rationale: Maintaining functional ability is a priority in COPD to preserve quality of life and independence. Chest pain is not a primary issue. Increasing CO2 is harmful. Treating infections is important but not the top goal.
Which of the following indicates a potential complication of diabetes mellitus?
- A. Inflamed, painful joints.
- B. Blood pressure of 160/100 mm Hg.
- C. Hemoglobin of 11 g/dL.
- D. Fasting blood glucose of 90 mg/dL.
Correct Answer: B
Rationale: Hypertension (160/100 mm Hg) is a common complication of diabetes, contributing to cardiovascular and kidney disease.