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A patient with bipolar disorder is prescribed lithium. What dietary advice should the nurse provide?
- A. Increase intake of caffeine.
- B. Maintain a consistent salt intake.
- C. Avoid dairy products.
- D. Increase intake of green leafy vegetables.
Correct Answer: B
Rationale: The correct answer is B: Maintain a consistent salt intake. Lithium can affect sodium levels in the body, so it's important to maintain a consistent salt intake to prevent lithium toxicity or imbalance. Increasing caffeine intake (choice A) can worsen symptoms of bipolar disorder. Avoiding dairy products (choice C) is not necessary for lithium therapy. Increasing intake of green leafy vegetables (choice D) is generally healthy but not specifically recommended for lithium therapy. Maintaining a consistent salt intake is crucial in managing the effects of lithium on sodium levels.
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A patient with hyperthyroidism is to receive radioactive iodine therapy. What information should the nurse include in the patient teaching plan?
- A. Avoid close contact with pregnant women for one week.
- B. Take iodine supplement daily.
- C. Restrict fluid intake to 1 liter per day.
- D. Use disposable utensils for all meals.
Correct Answer: A
Rationale: The correct answer is A. The rationale is that radioactive iodine therapy can harm a developing fetus, so patients should avoid close contact with pregnant women for one week. Choice B is incorrect as iodine supplements can interfere with the therapy. Choice C is incorrect as fluid intake should not be restricted unless specifically advised by the healthcare provider. Choice D is incorrect as there is no need to use disposable utensils for all meals.
A patient with a diagnosis of peptic ulcer disease is prescribed omeprazole. When should the patient take this medication for optimal effectiveness?
- A. With meals
- B. At bedtime
- C. Before meals
- D. After meals
Correct Answer: C
Rationale: The correct answer is C: Before meals. Omeprazole is a proton pump inhibitor that works by reducing stomach acid production. Taking it before meals allows the medication to be most effective in inhibiting the proton pumps before they are stimulated by food intake. This timing optimizes the drug's ability to reduce acid secretion during the digestion process.
Choice A (With meals) is incorrect because taking omeprazole with meals may reduce its effectiveness as it will not have enough time to inhibit acid production before food intake. Choice B (At bedtime) is also incorrect as omeprazole works best when taken before meals to prevent acid production. Choice D (After meals) is incorrect because waiting until after meals to take omeprazole means that acid production has already been stimulated by the food consumed, reducing the drug's effectiveness in inhibiting acid secretion.
What side effect should be monitored for in a patient with chronic heart failure taking spironolactone?
- A. Hypokalemia
- B. Hyperkalemia
- C. Hyponatremia
- D. Hypernatremia
Correct Answer: B
Rationale: The correct answer is B: Hyperkalemia. Spironolactone is a potassium-sparing diuretic commonly used in patients with heart failure. It works by blocking the aldosterone receptor, leading to potassium retention and potential hyperkalemia. Monitoring potassium levels is crucial as hyperkalemia can increase the risk of arrhythmias and other cardiac complications in heart failure patients.
A: Hypokalemia is incorrect because spironolactone typically causes potassium retention.
C: Hyponatremia and D: Hypernatremia are incorrect as spironolactone does not directly affect sodium levels.
In summary, monitoring for hyperkalemia is essential in patients with heart failure taking spironolactone to prevent adverse cardiac events.
A patient who is diagnosed with cervical cancer that is classified as Tis, N0, M0 asks the nurse what the letters and numbers mean. Which response by the nurse is most appropriate?
- A. The cancer involves only the cervix.
- B. The cancer cells closely resemble normal cells.
- C. Further testing is necessary to determine the spread of the cancer.
- D. Determining the original site of the cervical cancer is challenging.
Correct Answer: A
Rationale: Step-by-step rationale for why answer A is correct:
1. Tis refers to carcinoma in situ, meaning the cancer is limited to the surface layer of cells in the cervix.
2. N0 indicates no regional lymph node involvement.
3. M0 indicates no distant metastasis.
4. Therefore, the cancer is localized only to the cervix, making answer A correct.
Summary:
B: Incorrect - Does not address the staging information provided in Tis, N0, M0.
C: Incorrect - The staging information is already provided, and further testing may not be necessary at this stage.
D: Incorrect - Staging information does not indicate difficulty in determining the original site of the cancer.
What is the primary cause of jaundice in a client with liver cirrhosis?
- A. Decreased bile production
- B. Increased bilirubin levels
- C. Hepatic inflammation
- D. Portal hypertension
Correct Answer: B
Rationale: The primary cause of jaundice in a client with liver cirrhosis is increased bilirubin levels. Liver cirrhosis impairs the liver's ability to process bilirubin, leading to its accumulation in the bloodstream. This excess bilirubin then causes the yellow discoloration of the skin and eyes characteristic of jaundice.
Incorrect Choices:
A: Decreased bile production is not the primary cause of jaundice in liver cirrhosis. While decreased bile flow may contribute to jaundice, it is secondary to the impaired bilirubin processing.
C: Hepatic inflammation is a common feature of liver cirrhosis but is not the direct cause of jaundice in this context.
D: Portal hypertension is a complication of liver cirrhosis but is not the primary cause of jaundice.