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A nurse is caring for a client who has end-stage kidney disease. The client has decided to stop dialysis treatment. Which of the following actions should the nurse take?
- A. Tell the client she should discuss this decision with her family.
- B. Support the client's decision to stop the treatment.
- C. Discuss alternative treatment methods with the client.
- D. Ask the facility chaplain to visit the client.
Correct Answer: B
Rationale: Supporting the client's decision respects autonomy, a core ethical principle. Discussing with family, alternatives, or involving a chaplain are secondary to honoring the client's choice.
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A nurse is reinforcing teaching with a client who has a new prescription for gabapentin. Which of the following statements by the client indicates an understanding of the teaching?
- A. I should take this medication with a high-fat meal.
- B. I might feel sleepy while taking this medication.
- C. I need to avoid sunlight while taking this medication.
- D. I can stop taking this medication as soon as my pain goes away.
Correct Answer: B
Rationale: Gabapentin can cause drowsiness, reflecting understanding. Food intake is flexible, sunlight isn't a concern, and stopping needs tapering.
A nurse is caring for a client who is receiving magnesium sulfate IV for preeclampsia. Which of the following findings indicates the medication is effective?
- A. Increased blood pressure
- B. Decreased respiratory rate
- C. Increased urine output
- D. Decreased deep tendon reflexes
Correct Answer: C
Rationale: Magnesium sulfate promotes diuresis, so increased urine output indicates effectiveness in managing fluid overload in preeclampsia.
A nurse is reinforcing teaching with a client who has a new prescription for levothyroxine. Which of the following statements by the client indicates an understanding of the teaching?
- A. I should take this medication with a meal to avoid stomach upset.
- B. I might not notice the effects of this medication for several weeks.
- C. I will need to decrease my intake of green, leafy vegetables.
- D. I can take an antacid with this medication if I get heartburn.
Correct Answer: B
Rationale: Levothyroxine's effects take weeks to manifest, reflecting proper understanding. It's taken on an empty stomach, diet doesn't need altering, and antacids can interfere.
A nurse is caring for a client who is receiving IV heparin. Which of the following findings should the nurse report to the provider?
- A. The client reports mild bruising.
- B. The client's aPTT is 90 seconds.
- C. The client's blood pressure is 122/80 mm Hg.
- D. The client's urine output is 40 mL/hr.
Correct Answer: B
Rationale: An aPTT of 90 seconds (above therapeutic range of 60-80) suggests excessive anticoagulation, requiring reporting. Bruising, normal BP, and urine output are less urgent.
A nurse is caring for a client who has a new prescription for heparin. Which of the following laboratory values should the nurse monitor?
- A. Potassium
- B. Hemoglobin
- C. Partial thromboplastin time (PTT)
- D. Blood urea nitrogen (BUN)
Correct Answer: C
Rationale: Heparin's anticoagulant effect is monitored via PTT to ensure therapeutic dosing. Potassium, hemoglobin, or BUN aren't directly affected by heparin.