Nokea
A nurse is teaching a client who has been taking prednisone to treat asthma and has a new prescription to discontinue the medication. The nurse should explain to the client to reduce the dose gradually to prevent which of the following adverse effects?
- A. Osteoporosis
- B. Hypoglycemia
- C. Hyperkalemia
- D. Adrenocortical insufficiency
Correct Answer: D
Rationale: The correct answer is D: Adrenocortical insufficiency. Gradually reducing prednisone dose is important as prednisone suppresses the body's natural production of cortisol. Abrupt discontinuation can lead to adrenal insufficiency due to the sudden decrease in cortisol levels. This can result in symptoms such as fatigue, weakness, weight loss, and hypotension. Osteoporosis (A) is a long-term side effect of prednisone but not a concern with dose reduction. Hypoglycemia (B) and Hyperkalemia (C) are not typically associated with prednisone withdrawal.
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A nurse is admitting a client who has acute pancreatitis. Which of the following provider prescriptions should the nurse anticipate?
- A. Pantoprazole 80 mg IV bolus twice daily
- B. Furosemide 40 mg IV
- C. Lactulose 20 mg PO
- D. Acetaminophen 650 mg PO
Correct Answer: A
Rationale: The correct answer is A: Pantoprazole 80 mg IV bolus twice daily. In acute pancreatitis, gastric acid hypersecretion can occur, leading to exacerbation of pancreatic inflammation. Pantoprazole is a proton pump inhibitor that helps reduce gastric acid secretion, which can alleviate pancreatic irritation. IV administration ensures rapid onset of action.
B: Furosemide is a diuretic used for conditions like heart failure or edema, not indicated for acute pancreatitis.
C: Lactulose is a laxative used for hepatic encephalopathy to reduce ammonia levels, not indicated for acute pancreatitis.
D: Acetaminophen is a pain reliever, but it does not address the underlying cause of acute pancreatitis.
A nurse is admitting a client who has a serum calcium level of 12.3 mg/dL and initiates cardiac monitoring. Which of the following findings should the nurse expect during the initial assessment?
- A. Lethargy
- B. Hypertension
- C. Muscle spasms
- D. Severe agitation
Correct Answer: A
Rationale: The correct answer is A: Lethargy. A serum calcium level of 12.3 mg/dL indicates hypercalcemia. In hypercalcemia, calcium affects the central nervous system, leading to lethargy, weakness, and confusion. Lethargy is a common early symptom of hypercalcemia. Hypertension is not typically associated with hypercalcemia. Muscle spasms are more common in hypocalcemia. Severe agitation is not a typical manifestation of hypercalcemia.
A nurse is monitoring a client who has a chest tube in place connected to wall suction due to a right-sided pneumothorax. The client complains of chest burning. Which of the following actions should the nurse take?
- A. Reposition the client
- B. Check the chest tube for kinks
- C. Increase the suction pressure
- D. Administer pain medication
Correct Answer: A
Rationale: Repositioning the client can help alleviate chest burning caused by the chest tube.
A female middle adult client tells a nurse that she tested positive for a mutant BRCA1 gene. The nurse should recognize that the client is at an increased risk for which of the following situations?
- A. Developing breast cancer
- B. Developing ovarian cancer
- C. Developing uterine cancer
- D. Developing cervical cancer
Correct Answer: A
Rationale: The correct answer is A: Developing breast cancer. The BRCA1 gene mutation is associated with an increased risk of breast cancer in women. The mutation affects the body's ability to repair damaged DNA, leading to a higher likelihood of developing breast cancer. This risk is significantly higher in women with the mutant BRCA1 gene compared to those without it. Choices B, C, and D are incorrect because the BRCA1 gene mutation is not specifically linked to an increased risk of ovarian, uterine, or cervical cancer. Therefore, the client should be counseled and monitored closely for early detection and prevention of breast cancer.
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.