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A nurse is teaching a client with a history of calcium oxalate kidney stones. What advice should be given?
- A. Limit fluid intake to 1 L per day.
- B. Drink 3 L of fluid every day.
- C. Increase calcium intake.
- D. Avoid all citrus juices.
Correct Answer: B
Rationale: The correct answer is B: Drink 3 L of fluid every day. Increasing fluid intake helps prevent the formation of kidney stones by diluting the urine and reducing the concentration of minerals like calcium oxalate. Adequate hydration promotes frequent urination, which helps flush out these minerals. Limiting fluid intake (choice A) can lead to concentrated urine and increase the risk of stone formation. Increasing calcium intake (choice C) can actually help prevent calcium oxalate stones, as calcium binds with oxalate in the intestines, reducing its absorption. Avoiding all citrus juices (choice D) is unnecessary, as they do not directly contribute to the formation of calcium oxalate stones.
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A nurse is reviewing the EKG strip of a client who has prolonged vomiting. Which of the following abnormalities on the client's EKG should the nurse interpret as a sign of hypokalemia?
- A. Flat T wave
- B. Prominent U wave
- C. ST elevation
- D. Wide QRS complex
Correct Answer: B
Rationale: The correct answer is B: Prominent U wave. Hypokalemia, or low potassium levels, can cause the U wave to become more prominent on an EKG strip. This is due to delayed repolarization of the ventricles. A flat T wave (choice A) is typically associated with ischemia or infarction. ST elevation (choice C) is often seen in conditions like myocardial infarction. A wide QRS complex (choice D) is indicative of conduction abnormalities. Choices E, F, and G are not relevant to the interpretation of hypokalemia on an EKG strip.
A nurse is providing discharge teaching to a client who has asthma and a new prescription for fluticasone/salmeterol. For which of the following adverse effects should the nurse instruct the client to report to the provider?
- A. White coating in the mouth
- B. Increased heart rate
- C. Insomnia
- D. Shortness of breath
Correct Answer: A
Rationale: The correct answer is A: White coating in the mouth. This adverse effect can indicate oral thrush, a fungal infection common with inhaled corticosteroids like fluticasone. The nurse should instruct the client to report this to the provider promptly for appropriate treatment. Increased heart rate (B) and insomnia (C) are common side effects of the medication but not usually serious enough to report immediately. Shortness of breath (D) is a symptom of poorly controlled asthma and should be addressed promptly but not considered an adverse effect of the medication in this context.
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.
A nurse is caring for a client who develops a ventricular fibrillation rhythm. The client is unresponsive, pulseless, and apneic. Which of the following actions is the nurse's priority?
- A. Defibrillation
- B. Administer oxygen
- C. Call for help
- D. Start chest compressions
Correct Answer: A
Rationale: The correct answer is A: Defibrillation. Ventricular fibrillation is a life-threatening arrhythmia that requires immediate defibrillation to restore the heart's normal rhythm. Defibrillation is the priority as it is the most effective intervention to treat ventricular fibrillation and increase the chance of survival. Administering oxygen (B) is important but not the priority over defibrillation. Calling for help (C) should be done after initiating defibrillation. Starting chest compressions (D) should only be done if defibrillation is not immediately available or unsuccessful.
A nurse in a cardiac care unit is caring for a client with acute right-sided heart failure. Which of the following findings should the nurse expect?
- A. Low blood pressure
- B. Elevated central venous pressure (CVP).
- C. Decreased urine output
- D. Increased lung crackles
Correct Answer: B
Rationale: The correct answer is B: Elevated central venous pressure (CVP). In right-sided heart failure, the right ventricle fails to effectively pump blood to the lungs, causing blood to back up in the systemic circulation. This leads to increased pressure in the venous system, including the central veins. Elevated CVP is a classic sign of right-sided heart failure. Low blood pressure (A) is more commonly associated with left-sided heart failure. Decreased urine output (C) may occur due to poor perfusion but is not specific to right-sided heart failure. Increased lung crackles (D) are typically seen in left-sided heart failure, not right-sided heart failure.