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A nurse is caring for a client who has a new temporary synchronous pacemaker. Which of the following should the nurse report to the provider?
- A. The client's pulse oximetry level is 96%.
- B. The client develops hiccups.
- C. The ECG shows pacing spikes after the QRS complex.
- D. The client's heart rate is 90 beats per minute.
Correct Answer: C
Rationale: The correct answer is C. Pacing spikes after the QRS complex indicate a malfunction of the pacemaker and should be reported. Choice A is not directly related to the pacemaker function. Choice B, hiccups, are common and not typically associated with pacemaker issues. Choice D, a heart rate of 90 beats per minute, is within the normal range and does not indicate a pacemaker malfunction.
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A nurse is caring for a client who is scheduled for a colonoscopy. Which of the following findings should the nurse report to the provider?
- A. Client reports taking ibuprofen daily
- B. Client has a history of asthma
- C. Client reports drinking one glass of wine daily
- D. Client has a history of diverticulitis
Correct Answer: A
Rationale: The correct answer is A. Ibuprofen is an NSAID that can increase the risk of bleeding during a colonoscopy due to its effects on platelet function. It is important to report this finding to the provider to consider alternative pain management options. Choices B, C, and D are not the most pertinent to report for a colonoscopy. Asthma and a history of diverticulitis are relevant medical history but do not directly impact the colonoscopy procedure. Drinking one glass of wine daily is not a concern specifically related to the colonoscopy procedure.
A client who is at 10 weeks of gestation and experiencing nausea and vomiting is receiving teaching from a nurse. Which of the following statements should the nurse include?
- A. You should eat crackers before getting out of bed.
- B. You should drink ginger ale with your meals.
- C. You should lie down for 30 minutes after eating.
- D. You should avoid eating between meals.
Correct Answer: A
Rationale: The correct answer is A: 'You should eat crackers before getting out of bed.' Eating crackers before getting out of bed can help reduce nausea and vomiting during pregnancy. This recommendation helps in stabilizing blood sugar levels before fully waking up. Choice B is incorrect because ginger ale may exacerbate nausea due to its carbonation. Choice C is incorrect as lying down after eating can worsen symptoms of nausea. Choice D is incorrect as avoiding eating between meals can lead to low blood sugar levels, worsening nausea and vomiting.
A nurse is providing teaching to a client who has a new prescription for digoxin. Which of the following instructions should the nurse include?
- A. Avoid taking this medication with antacids.
- B. Contact your provider if you experience visual changes.
- C. Increase your intake of foods high in potassium.
- D. You may experience increased urination while taking this medication.
Correct Answer: B
Rationale: The correct answer is B: 'Contact your provider if you experience visual changes.' Visual changes, such as blurred or yellow vision, can indicate digoxin toxicity and should be reported immediately to the healthcare provider for further evaluation and management. Choice A is incorrect because digoxin can be taken with antacids. Choice C is incorrect because increasing potassium intake can lead to hyperkalemia when taking digoxin. Choice D is incorrect because increased urination is not a common side effect of digoxin.
A nurse is providing dietary teaching to a client with irritable bowel syndrome (IBS). What recommendation should be included?
- A. Consume foods high in bran fiber.
- B. Increase intake of milk products.
- C. Sweeten foods with fructose corn syrup.
- D. Increase intake of foods high in gluten.
Correct Answer: A
Rationale: The correct answer is A: Consume foods high in bran fiber. Bran fiber is recommended for clients with IBS as it promotes regularity and helps reduce symptoms. Choices B, C, and D are incorrect. Increasing milk products may exacerbate symptoms in some individuals with IBS due to lactose intolerance. Sweetening foods with fructose corn syrup can worsen symptoms as it is a type of sugar that can lead to gastrointestinal discomfort. Increasing intake of foods high in gluten is not recommended for individuals with IBS, especially those with gluten sensitivity, as it may trigger or worsen symptoms.
A nurse is reviewing the medical record of a client who has a prescription for spironolactone. Which of the following findings should the nurse report to the provider?
- A. Potassium 5.0 mEq/L
- B. Blood pressure 136/84 mm Hg
- C. Sodium 140 mEq/L
- D. Calcium 9.5 mg/dL
Correct Answer: A
Rationale: A potassium level of 5.0 mEq/L is at the upper limit of normal and should be monitored closely in clients taking spironolactone, which is potassium-sparing. Elevated potassium levels can lead to hyperkalemia, especially in individuals on potassium-sparing diuretics like spironolactone. Monitoring and reporting high potassium levels are crucial to prevent potential complications such as cardiac arrhythmias. Blood pressure (choice B), sodium level (choice C), and calcium level (choice D) are not directly related to the use of spironolactone and do not require immediate reporting in this scenario.