Nokea
A nurse is preparing to administer 0.9% sodium chloride IV infusion 1000 mL bag at a rate of 200 mL/hr for a client who has rhabdomyolysis. The nurse should expect the IV pump to infuse over how many hours? (Round the answer to the nearest whole number. (Use a leading zero if it applies. Do not use a trailing zero))
- A. 5 hours
- B. 4 hours
- C. 6 hours
- D. 7 hours
Correct Answer: A
Rationale: 1000 mL ÷ 200 mL/hr = 5 hours. The infusion will take 5 hours.
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A nurse is reinforcing teaching for a client about following a low-purine diet to manage gout. Which of the following statements should the nurse identify as an indication that the client understands the instructions?
- A. I'll drink white wine, not red.
- B. I'll limit the number of fruit servings I eat each day.
- C. I'll choose red meat instead of poultry.
- D. I'll eliminate liver from my diet.
Correct Answer: D
Rationale: Organ meats like liver are high in purines and should be eliminated to manage gout effectively, as purines increase uric acid levels.
A nurse is collecting data from a client who has diabetes mellitus. The client is confused, flushed, and has an acetone odor on his breath. The nurse should anticipate a prescription for which of the following types of insulin to treat the client?
- A. Regular.
- B. NPH.
- C. Glargine.
- D. Detemir.
Correct Answer: A
Rationale: Regular insulin is a short-acting insulin used to treat diabetic ketoacidosis (DKA), which is indicated by the client's symptoms of confusion, flushed appearance, and acetone odor on the breath.
A nurse is caring for a client who has a new diagnosis of urolithiasis. Which of the following risk factors should the nurse identify as contributing to this diagnosis?
- A. High-purine diet.
- B. Low levels of serum calcium.
- C. Female gender.
- D. Drinking large quantities of fluids.
Correct Answer: A
Rationale: A high-purine diet increases uric acid, forming crystals and stones, contributing to urolithiasis.
A nurse is reinforcing discharge teaching with a client who has osteoarthritis. Which of the following statements by the client indicates an understanding of the teaching?
- A. Osteoarthritis is caused by inflammation that affects both joints and other body tissues.
- B. Osteoarthritis happens in several phases when deposits of crystals develop in joints and soft tissues.
- C. Osteoarthritis occurs due to the aging process and results in disintegration of cartilage in a joint.
- D. Osteoarthritis is due to loss of calcium in the bones, which can lead to increased risk for bone fractures.
Correct Answer: C
Rationale: Osteoarthritis is a degenerative joint disease due to aging and cartilage disintegration, as correctly understood.
A nurse is admitting a client who reports recurrent flank pain and nausea for 24 hr. Which of the following actions should the nurse take first?
- A. Monitor intake and output.
- B. Administer pain medication.
- C. Ambulate in hall.
- D. Strain the urine.
Correct Answer: B
Rationale: Administering pain medication is the priority to alleviate discomfort, allowing for further assessment and treatment.