Nokea
A nurse is teaching a middle-aged client about hypertension. Which of the following information should the nurse include in the teaching?
- A. Calcium channel blockers are the first choice for hypertension.
- B. Beta-blockers are the first type of medication for hypertension.
- C. ACE inhibitors are the first choice for hypertension.
- D. Diuretics are the first type of medication to control hypertension.
Correct Answer: A
Rationale: Diuretics are the first-line treatment for hypertension as they reduce blood volume, lowering blood pressure.
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A nurse is teaching about adverse effects of anastrozole with a client who has advanced breast cancer and is postmenopausal. Which of the following adverse effects should the nurse recommend the client report to the provider?
- A. Headache
- B. Nausea
- C. Musculoskeletal pain
- D. Fatigue
Correct Answer: C
Rationale: The correct answer is C: Musculoskeletal pain. Anastrozole, an aromatase inhibitor used in breast cancer treatment, can cause musculoskeletal pain as a common adverse effect. This is important to report because severe pain may indicate a more serious condition like osteoporosis or fractures. Headache, nausea, and fatigue are common side effects of anastrozole but usually not considered serious enough to report immediately. Summarily, while all options can occur with anastrozole, musculoskeletal pain warrants prompt reporting due to potential implications on bone health.
A nurse is providing teaching to a client who is postoperative following coronary artery bypass graft (CABG) surgery and is receiving opioid medications to manage discomfort. Aside from managing pain, which of the following desired effects of medications should the nurse identify as most important for the client's recovery?
- A. It facilitates the client's deep breathing
- B. It increases the client's appetite
- C. It promotes wound healing
- D. It decreases the client's anxiety
Correct Answer: A
Rationale: The correct answer is A: It facilitates the client's deep breathing. Postoperative clients following CABG surgery are at risk for developing atelectasis due to decreased lung expansion. Opioid medications can cause respiratory depression, leading to shallow breathing. By facilitating deep breathing, the nurse helps prevent atelectasis and promotes optimal oxygenation, aiding in the client's recovery. Choices B, C, and D are incorrect as they are not directly related to the immediate physiological needs of a postoperative CABG client. Increasing appetite, promoting wound healing, and decreasing anxiety are important aspects of overall recovery but are not as critical as ensuring proper oxygenation and preventing respiratory complications in the immediate postoperative period.
A nurse is reviewing the arterial blood gas values of a client who has chronic kidney disease. Which of the following sets of values should the nurse expect?
- A. pH 7.25, HCO3- 19 mEq/L, PaCO2 30 mm Hg
- B. pH 7.40, HCO3- 24 mEq/L, PaCO2 38 mm Hg
- C. pH 7.45, HCO3- 28 mEq/L, PaCO2 40 mm Hg
- D. pH 7.50, HCO3- 30 mEq/L, PaCO2 45 mm Hg
Correct Answer: A
Rationale: The correct answer is A (pH 7.25, HCO3- 19 mEq/L, PaCO2 30 mm Hg). In chronic kidney disease, the kidneys are unable to excrete acid effectively, leading to metabolic acidosis. The pH is low (acidotic) due to the accumulation of acids. The bicarbonate (HCO3-) is low (19 mEq/L) as the kidneys are unable to reabsorb and regenerate bicarbonate effectively. The PaCO2 is low (30 mm Hg) as the respiratory system compensates by increasing the respiratory rate to blow off carbon dioxide in an attempt to normalize the pH. Choices B, C, and D have pH values within normal range and do not reflect the expected acidosis in chronic kidney disease.
A nurse is teaching a class about preventive care to clients who are at risk for acquiring viral hepatitis. Which of the following information should the nurse include in the presentation?
- A. Avoid foods prepared with tap water.
- B. Vaccination against hepatitis B and C is recommended.
- C. Wash hands thoroughly after using the restroom.
- D. Food should be prepared with purified water.
Correct Answer: D
Rationale: The correct answer is D: Food should be prepared with purified water. Hepatitis A virus can be spread through contaminated water or food. Using purified water for food preparation can help prevent the transmission of the virus. Choice A is incorrect because avoiding foods prepared with tap water alone may not be sufficient to prevent hepatitis. Choice B is incorrect as there is no vaccination available for hepatitis C. Choice C is important for general hygiene but may not specifically prevent hepatitis transmission.
A nurse is caring for a client with a sucking chest wound from a gunshot. What action should the nurse take?
- A. Administer oxygen via nasal cannula.
- B. Place the client in Trendelenburg position.
- C. Apply a warm compress to the wound.
- D. Encourage deep breathing exercises.
Correct Answer: A
Rationale: The correct answer is A: Administer oxygen via nasal cannula. This is the priority action to ensure the client receives adequate oxygenation. In a sucking chest wound, air enters the pleural space, leading to a potential pneumothorax, which can compromise oxygenation. Administering oxygen helps maintain oxygen saturation levels and supports respiratory function. Placing the client in Trendelenburg position (choice B) can worsen respiratory distress by increasing pressure on the diaphragm. Applying a warm compress (choice C) may promote bleeding and is not effective in managing a sucking chest wound. Encouraging deep breathing exercises (choice D) can further exacerbate the pneumothorax by allowing more air to enter the pleural space.