Nokea
A nurse is caring for an older adult client who has rheumatoid arthritis (RA) and is taking aspirin 650 mg every 4 hours. Which of the following diagnostic tests should the nurse monitor to evaluate the effectiveness of this medication?
- A. C-reactive protein
- B. Erythrocyte sedimentation rate (ESR)
- C. White blood cell count
- D. Hematocrit
Correct Answer: B
Rationale: The correct answer is B: Erythrocyte sedimentation rate (ESR). ESR is a common test used to monitor inflammation levels in rheumatoid arthritis (RA) patients. Aspirin is an anti-inflammatory medication, so monitoring ESR can help assess the effectiveness of the treatment. A decrease in ESR levels indicates a reduction in inflammation, suggesting that the aspirin is working. The other choices (A, C, D) are not specific to monitoring the effectiveness of aspirin in RA. C-reactive protein and white blood cell count are general markers of inflammation and infection, not specific to RA. Hematocrit measures red blood cell levels, which are not directly related to the effectiveness of aspirin in treating RA.
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A nurse is planning an educational program about basal cell carcinoma. Which of the following information should the nurse plan to include?
- A. Basal cell carcinoma has a low incidence of metastasis.
- B. Basal cell carcinoma is often fatal.
- C. Basal cell carcinoma metastasizes early.
- D. Basal cell carcinoma is more common in younger clients.
Correct Answer: A
Rationale: The correct answer is A: Basal cell carcinoma has a low incidence of metastasis. Basal cell carcinoma rarely metastasizes to other parts of the body, making it highly curable through surgical excision. This information is crucial for patients to understand the low likelihood of the cancer spreading. Choices B and C are incorrect because basal cell carcinoma is not typically fatal nor does it metastasize early. Choice D is incorrect as basal cell carcinoma is more common in older adults, not younger clients.
A nurse is reviewing the laboratory findings for a client who developed fat embolism syndrome (FES) following a fracture. Which of the following laboratory findings should the nurse expect?
- A. Increased serum calcium level
- B. Decreased serum calcium level
- C. Increased white blood cell count
- D. Decreased platelet count
Correct Answer: B
Rationale: The correct answer is B: Decreased serum calcium level. In fat embolism syndrome (FES), fat globules enter the bloodstream, leading to blockages in small blood vessels. This can cause a decrease in serum calcium due to the formation of fat emboli in the pulmonary circulation, leading to hypoxia and subsequent release of inflammatory mediators that can affect calcium levels. The other choices are incorrect because in FES, there is no direct effect on serum calcium levels. Increased serum calcium levels (choice A) are not expected in FES. While increased white blood cell count (choice C) and decreased platelet count (choice D) can occur in response to inflammation or infection associated with FES, they are not specific laboratory findings for FES.
The nurse is caring for a client who has heart failure and a history of asthma. The nurse reviews the provider's orders and recognizes that clarification is needed for which of the following medications?
- A. Furosemide
- B. Carvedilol
- C. Spironolactone
- D. Lisinopril
Correct Answer: B
Rationale: The correct answer is B: Carvedilol. Carvedilol is a beta-blocker, which can exacerbate asthma symptoms in clients with a history of asthma due to its potential bronchoconstrictive effects. Furosemide (A), Spironolactone (C), and Lisinopril (D) are commonly used in heart failure management and do not pose a significant risk for clients with asthma. It is crucial to avoid medications that can worsen respiratory function in clients with a history of asthma to prevent complications.
A client is receiving treatment for stage IV ovarian cancer and asks the nurse to discuss her prognosis. The client plans to have aggressive surgical, radiation, and chemotherapy treatments. Which of the following prognoses should the nurse discuss with the client?
- A. Poor
- B. Favorable
- C. Uncertain
- D. Excellent
Correct Answer: A
Rationale: The correct answer is A: Poor. In stage IV ovarian cancer, the cancer has spread beyond the ovaries to distant organs, resulting in a poor prognosis. The aggressive treatments may help manage symptoms and prolong survival but the overall prognosis remains poor due to the advanced stage of the cancer. Choice B (Favorable) is incorrect because stage IV ovarian cancer has a poor prognosis. Choice C (Uncertain) is incorrect as the prognosis for stage IV ovarian cancer is generally known to be poor. Choice D (Excellent) is incorrect as stage IV ovarian cancer is not associated with an excellent prognosis due to its advanced stage.
A nurse is providing teaching for a client who has hypertension and a prescription change from metoprolol to metoprolol/hydrochlorothiazide. Which of the following statements by the client indicates an understanding of the teaching?
- A. With the new medication, I should experience fewer side effects.
- B. I can expect an increase in my blood pressure.
- C. I should expect the medication to work immediately.
- D. I will stop taking the medication when I feel better.
Correct Answer: A
Rationale: The correct answer is A. By stating that with the new medication, the client should experience fewer side effects, the client demonstrates understanding that the addition of hydrochlorothiazide may help reduce side effects compared to taking metoprolol alone. This indicates comprehension of the teaching provided by the nurse.
Choice B is incorrect because the client should not expect an increase in blood pressure with the new medication regimen.
Choice C is incorrect as it typically takes time for medications to reach their full effectiveness, so immediate results are not expected.
Choice D is incorrect because stopping medication when feeling better can lead to a worsening of hypertension and other health issues.
Overall, choice A is the best response as it shows an understanding of the medication change and its potential benefits.