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A nurse is reviewing the laboratory test results from a client who has prerenal acute kidney injury (AKI). Which of the following electrolyte imbalances should the nurse expect?
- A. Hypophosphatemia
- B. Hyperkalemia
- C. Hypercalcemia
- D. Hypernatremia
Correct Answer: B
Rationale: The correct answer is B: Hyperkalemia. In prerenal AKI, decreased blood flow to the kidneys leads to reduced filtration and impaired excretion of potassium, resulting in hyperkalemia. Hypophosphatemia (A), hypercalcemia (C), and hypernatremia (D) are not typically associated with prerenal AKI. In prerenal AKI, there is usually no significant change in phosphate levels, calcium levels are typically normal or low due to volume depletion, and sodium levels may be normal or decreased due to reduced renal perfusion.
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A nurse is presenting a community-based program about HIV and AIDS. A client asks the nurse to describe the initial symptoms experienced with HIV infection. Which of the following manifestations should the nurse include in the explanation of initial symptoms?
- A. Flu-like symptoms and night sweats
- B. Fungal and bacterial infections
- C. Pneumocystis lung infection
- D. Kaposi’s sarcoma
Correct Answer: A
Rationale: The correct answer is A: Flu-like symptoms and night sweats. Initial symptoms of HIV infection often present as flu-like symptoms such as fever, fatigue, sore throat, swollen lymph nodes, and night sweats. This is known as acute retroviral syndrome and occurs within the first few weeks after exposure to the virus. These symptoms are nonspecific and can easily be mistaken for other common illnesses. Fungal and bacterial infections (B), Pneumocystis lung infection (C), and Kaposi’s sarcoma (D) are not initial symptoms of HIV infection. Fungal and bacterial infections typically occur in later stages of HIV when the immune system is severely compromised. Pneumocystis lung infection and Kaposi’s sarcoma are opportunistic infections seen in advanced stages of HIV, usually when the CD4 count is significantly low.
A nurse is preparing to administer amitriptyline 150 mg PO at bedtime. The amount available is amitriptyline 75 mg tablet. How many tablets should the nurse administer per dose? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)
Correct Answer: 2
Rationale: The nurse should administer 2 tablets of amitriptyline 75 mg each to achieve a total dose of 150 mg. Since each tablet is 75 mg, 2 tablets would equal 150 mg. This ensures the patient receives the prescribed dose accurately. Other choices are incorrect because administering 1 tablet would result in only 75 mg, insufficient for the prescribed dose. Administering 3 tablets would exceed the prescribed dose, leading to potential overdose. Choices above 3 tablets are also incorrect as they would significantly exceed the prescribed 150 mg dose, risking adverse effects.
A nurse is planning care for a client who is 2 hours postoperative following a transurethral resection of the prostate. The client is receiving continuous bladder irrigation. Which of the following interventions should the nurse include?
- A. Restrict the client’s oral fluid intake.
- B. Remind the client he might feel a constant urge to void.
- C. Weigh the client every evening.
- D. Monitor the client’s urine output every 6 hours.
Correct Answer: B
Rationale: The correct answer is B: Remind the client he might feel a constant urge to void. After a transurethral resection of the prostate, continuous bladder irrigation is often used to prevent blood clots and ensure urine output. This procedure can cause the client to feel a constant urge to void due to the bladder being continuously filled and emptied. Therefore, reminding the client about this sensation can help alleviate anxiety and discomfort.
Choice A: Restricting the client's oral fluid intake is incorrect because maintaining hydration is essential postoperatively to prevent complications such as dehydration and urinary retention.
Choice C: Weighing the client every evening is unnecessary and not directly related to the care of a client post transurethral resection of the prostate.
Choice D: Monitoring the client's urine output every 6 hours is important, but reminding the client about the sensation of constant urge to void takes priority in this scenario.
A nurse is caring for a client who is 1 day postoperative following a transsphenoidal hypophysectomy. While assessing the client, the nurse notes a large area of clear drainage seeping from the nasal packing. Which of the following should be the nurse’s initial action?
- A. Check the drainage for glucose.
- B. Notify the client’s provider.
- C. Document the amount of drainage.
- D. Obtain a culture of the drainage.
Correct Answer: A
Rationale: The correct initial action is to check the drainage for glucose (Choice A). This is crucial because clear drainage after a transsphenoidal hypophysectomy may indicate a cerebrospinal fluid leak, which can be confirmed by the presence of glucose in the drainage. If glucose is present, it suggests leakage of cerebrospinal fluid and requires immediate intervention to prevent complications such as infection and meningitis. The other options (B, C, and D) are not the most appropriate initial actions. Notifying the provider, documenting the amount of drainage, or obtaining a culture can be important steps but should come after confirming the presence of glucose to address the immediate concern of a potential cerebrospinal fluid leak.
A nurse is assessing a client who has hyperthyroidism. The nurse should expect the client to report which of the following manifestations?
- A. Constipation
- B. Sensitivity to cold
- C. Weight gain of 4.5 kg (10 lbs) in 3 weeks
- D. Frequent mood changes
Correct Answer: D
Rationale: The correct answer is D: Frequent mood changes. In hyperthyroidism, there is an excessive production of thyroid hormones leading to symptoms such as irritability, anxiety, and mood swings. This is due to the increased metabolic activity caused by the excess thyroid hormones. Constipation (A) is more common in hypothyroidism. Sensitivity to cold (B) is also seen in hypothyroidism due to decreased metabolic rate. Weight gain of 4.5 kg (10 lbs) in 3 weeks (C) is unlikely in hyperthyroidism as it usually leads to weight loss. Therefore, choice D is the most appropriate manifestation for hyperthyroidism.