A nurse is providing education to a patient with chronic liver disease. The nurse should educate the patient to monitor for signs of which of the following complications?
- A. Hypoglycemia.
- B. Hyperglycemia.
- C. Jaundice.
- D. Anemia.
Correct Answer: C
Rationale: The correct answer is C: Jaundice. Patients with chronic liver disease are at risk for developing jaundice due to impaired liver function leading to the accumulation of bilirubin. Jaundice is characterized by yellowing of the skin and eyes. Monitoring for jaundice is crucial as it indicates worsening liver function.
Incorrect choices:
A: Hypoglycemia - Not directly related to chronic liver disease, more commonly seen in diabetes.
B: Hyperglycemia - Not typically associated with chronic liver disease unless the patient has underlying diabetes.
D: Anemia - Can be a complication of chronic liver disease, but monitoring for jaundice takes priority due to its direct association with liver dysfunction.
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A nurse is caring for a patient with chronic asthma. The nurse should monitor the patient for which of the following complications of asthma?
- A. Hypoglycemia.
- B. Oxygen toxicity.
- C. Hyperkalemia.
- D. Respiratory failure.
Correct Answer: D
Rationale: The correct answer is D: Respiratory failure. In chronic asthma, persistent inflammation and airway remodeling can lead to worsening lung function and respiratory distress, ultimately resulting in respiratory failure. Monitoring for signs of respiratory distress such as increased work of breathing, decreased oxygen saturation, and altered mental status is crucial.
A: Hypoglycemia is not a typical complication of asthma.
B: Oxygen toxicity is not a common complication in asthma management unless high concentrations of supplemental oxygen are administered for prolonged periods.
C: Hyperkalemia is not directly associated with asthma but may occur as a complication of certain asthma treatments or comorbid conditions.
Therefore, the priority complication to monitor in a patient with chronic asthma is respiratory failure due to the progressive nature of the disease and the potential for acute exacerbations.
A nurse is caring for a patient who is post-operative following hip replacement surgery. Which of the following should be included in the nursing care plan to prevent complications?
- A. Encouraging the patient to avoid physical activity for several weeks.
- B. Administering pain medication only when requested by the patient.
- C. Monitoring the patient for signs of infection and deep vein thrombosis.
- D. Providing education on safe lifting techniques.
Correct Answer: C
Rationale: The correct answer is C because monitoring the patient for signs of infection and deep vein thrombosis is crucial in preventing complications post-hip replacement surgery. Infections can lead to serious complications, while deep vein thrombosis can result in blood clots that can be life-threatening. By closely monitoring for these signs, the nurse can intervene early and prevent further complications.
Choice A is incorrect because complete avoidance of physical activity can lead to other complications such as muscle atrophy and delayed recovery. Choice B is incorrect because pain management should be proactive to prevent unnecessary suffering. Choice D, while important, is not directly related to preventing complications such as infection and deep vein thrombosis.
A nurse is teaching a patient with asthma about proper inhaler use. Which of the following statements by the patient indicates the need for further education?
- A. I should hold my breath for 10 seconds after inhaling the medication.
- B. I should use my inhaler before exercise to prevent symptoms.
- C. I can use my inhaler every 30 minutes if I have trouble breathing.
- D. I should rinse my mouth after using my inhaler to prevent thrush.
Correct Answer: C
Rationale: The correct answer is C because using the inhaler every 30 minutes for trouble breathing is not recommended. Overuse can lead to medication side effects and potential worsening of symptoms.
A: Holding breath after inhaling helps medication reach lungs.
B: Using inhaler before exercise can prevent exercise-induced symptoms.
D: Rinsing mouth prevents thrush, a common side effect of inhaled corticosteroids.
A nurse is teaching a patient with diabetes about self-management. Which of the following statements by the patient indicates the need for further education?
- A. I will check my blood sugar regularly.
- B. I will take my insulin only when my blood sugar is high.
- C. I will eat a balanced diet and exercise regularly.
- D. I will report any signs of infection to my healthcare provider.
Correct Answer: B
Rationale: Correct Answer: B
Rationale:
1. Taking insulin only when blood sugar is high can lead to uncontrolled levels.
2. Regular insulin dosing is essential for diabetes management.
3. Monitoring blood sugar regularly helps in adjusting insulin doses.
4. Eating a balanced diet and exercising are key components of diabetes management.
5. Reporting signs of infection is crucial due to diabetes-related complications.
Which of the following responses might the nurse expect during the functional assessment of a patient whose leg is in a cast?
- A. "I broke my right leg in a car accident 2 weeks ago."
- B. "The pain is getting less, but I still need to take Tylenol."
- C. "I check the colour of my toes every evening just like I was taught."
- D. "I'm able to transfer myself from the wheelchair to the bed without help."
Correct Answer: D
Rationale: The correct answer is D because the nurse would expect the patient to demonstrate functional independence in activities like transferring from a wheelchair to the bed despite having a leg in a cast. This response indicates good mobility and strength, which are positive signs of recovery. Choices A, B, and C are incorrect as they do not directly address the functional assessment of the patient. Choice A provides historical information, choice B focuses on pain management, and choice C mentions a self-care routine that is not related to functional ability.