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A nurse is establishing health promotion goals for a female client who smokes cigarettes, has hypertension, and has a BMI of 26. Which of the following goals should the nurse include?
- A. The client will walk for 30 min 5 days a week.
- B. The client will quit smoking within 2 weeks.
- C. The client will reduce BMI to 22 in 6 months.
- D. The client will eat low-fat meals every day.
Correct Answer: A
Rationale: The correct answer is A: The client will walk for 30 min 5 days a week. Walking is a feasible and effective form of exercise for overall health promotion. It helps improve cardiovascular health, which is important for someone with hypertension. It also aids in weight management, addressing the client's elevated BMI. Additionally, it can assist in smoking cessation efforts by reducing cravings and stress. Quitting smoking (choice B) is crucial but may require a longer timeline. Reducing BMI to 22 in 6 months (choice C) may be too aggressive and unrealistic. Eating low-fat meals (choice D) is beneficial but focusing solely on diet may not address the client's overall health needs.
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A nurse in a provider's office is reviewing the laboratory results of a client who takes furosemide for hypertension. The nurse notes that the client's potassium level is 3.3 mEq/L. The nurse should monitor the client for which of the following complications?
- A. Hypertension
- B. Hyperkalemia
- C. Cardiac dysrhythmias
- D. Pulmonary edema
Correct Answer: C
Rationale: The correct answer is C: Cardiac dysrhythmias. Furosemide is a loop diuretic that can lead to hypokalemia, which is a potassium deficiency. A potassium level of 3.3 mEq/L is below the normal range (3.5-5.0 mEq/L) and can increase the risk of cardiac dysrhythmias due to the role potassium plays in maintaining the heart's electrical activity. Hypertension (A) is not directly related to low potassium levels. Hyperkalemia (B) is the opposite of what the client is experiencing. Pulmonary edema (D) is not typically associated with low potassium levels.
A nurse is instructing a client how to decrease the nausea associated with chemotherapy and radiation. Which of the following statements indicates an understanding of the teaching?
- A. I will eat food that are served at room temperature.
- B. I will eat food that is very hot.
- C. I will drink large amounts of fluids with meals.
- D. I will eat a large meal right before chemotherapy.
Correct Answer: A
Rationale: Correct Answer: A: "I will eat food that is served at room temperature."
Rationale: Eating foods at room temperature can help decrease nausea because hot foods may worsen nausea, while cold foods could cause stomach discomfort. Room temperature foods are generally easier on the stomach and may be better tolerated during chemotherapy and radiation. This choice demonstrates an understanding of how food temperature can impact nausea.
Summary of other choices:
B: Eating very hot food can actually worsen nausea.
C: Drinking large amounts of fluids with meals can dilute stomach acid and enzymes, potentially worsening nausea.
D: Eating a large meal right before chemotherapy can lead to increased nausea and discomfort.
A nurse is caring for a client who has myelosuppression after receiving chemotherapy. The nurse should monitor the client for which of the following adverse effects?
- A. Bleeding from the gums
- B. Chest pain
- C. Fatigue
- D. Severe headache
Correct Answer: A
Rationale: The correct answer is A: Bleeding from the gums. Myelosuppression leads to decreased production of blood cells, including platelets, which are essential for clotting. Bleeding from the gums is a common sign of thrombocytopenia, a condition where there are low platelet levels. Chest pain, fatigue, and severe headache are not directly associated with myelosuppression. Monitoring for bleeding tendencies is crucial in clients with myelosuppression to prevent complications like hemorrhage.
A nurse is reviewing the laboratory data of a client who has acute pancreatitis. The nurse should expect to find an elevation of which of the following values?
- A. Creatinine
- B. Bilirubin
- C. Amylase
- D. Albumin
Correct Answer: C
Rationale: The correct answer is C: Amylase. In acute pancreatitis, there is inflammation of the pancreas leading to leakage of pancreatic enzymes like amylase into the blood. Elevated amylase levels are a hallmark of acute pancreatitis. Creatinine (A) is related to kidney function, bilirubin (B) to liver function, and albumin (D) to protein status. In acute pancreatitis, the focus is on pancreatic enzymes like amylase.
A nurse is reviewing the arterial blood gas (ABG) results of a client who the provider suspects has metabolic acidosis. Which of the following results should the nurse expect to see?
- A. pH below 7.35
- B. pH above 7.45
- C. HCO3- above 28 mEq/L
- D. PaCO2 above 45 mm Hg
Correct Answer: A
Rationale: The correct answer is A: pH below 7.35. In metabolic acidosis, there is a decrease in pH due to an excess of acid or a loss of bicarbonate ions. A pH below 7.35 indicates acidosis. Choices B and C are incorrect because in metabolic acidosis, the pH is below the normal range of 7.35-7.45, and the bicarbonate (HCO3-) level is typically below 24 mEq/L rather than above 28 mEq/L. Choice D is incorrect as an elevated PaCO2 (respiratory acidosis) is not typically seen in metabolic acidosis.