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A patient with chronic kidney disease is prescribed calcium carbonate as a phosphate binder. Which instruction should the nurse provide to the patient regarding calcium carbonate administration?
- A. Take with meals
- B. Take on an empty stomach
- C. Take with a full glass of water
- D. Crush tablets before administration
Correct Answer: A
Rationale: Calcium carbonate should be taken with meals because it requires the presence of stomach acid to be properly absorbed. Taking it with meals helps ensure optimal absorption and effectiveness as a phosphate binder in patients with chronic kidney disease. Administering calcium carbonate on an empty stomach may lead to gastrointestinal side effects such as upset stomach, bloating, and constipation. Taking it with a full glass of water is also recommended to help prevent potential gastrointestinal issues and to ensure proper hydration. Crushing tablets before administration is not advised unless specifically instructed by a healthcare provider, as it can alter the drug's release and absorption properties.
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A patient presents with a pruritic, eczematous rash with erythematous papules, vesicles, and excoriations on the flexural surfaces of the elbows and knees. The patient reports a personal history of asthma and hay fever. Which of the following conditions is most likely responsible for this presentation?
- A. Atopic dermatitis
- B. Contact dermatitis
- C. Seborrheic dermatitis
- D. Nummular eczema
Correct Answer: A
Rationale: Atopic dermatitis is a chronic, pruritic inflammatory skin condition that typically presents in individuals with a personal or family history of asthma and allergic rhinitis (hay fever). The characteristic presentation includes erythematous papules, vesicles, and excoriations on the flexural surfaces of the elbows and knees. This type of dermatitis is commonly seen in patients with atopy, which refers to a genetic predisposition to develop allergic diseases like asthma, hay fever, and eczema. Therefore, given the patient's personal history of asthma and hay fever along with the described rash distribution and appearance, atopic dermatitis is the most likely diagnosis.
It is not enough for the nurse to listen, but she also has, to validate what she has heard. The importance of validation are the following EXCEPT _____
- A. perceptions influence the interpretation of a message
- B. most patients are cognitively impaired
- C. Eye contact does not necessarily send the same message
- D. assists clarifying thoughts
Correct Answer: B
Rationale: The importance of validation in the context of communication and nursing care does not include the assumption that most patients are cognitively impaired. It would be more appropriate to approach patient interactions with the assumption that patients are capable of understanding and coherent communication. Validation is important because it helps ensure that the nurse has truly understood the patient's message, prevents misinterpretation, and fosters a sense of empathy and trust in the nurse-patient relationship. Additionally, validating the patient's thoughts and feelings can help clarify confused thoughts and promote effective communication. The other options (A, C, and D) are all valid reasons emphasizing the significance of validation in effective communication.
After five days of hospitalization, the physician said Mr. Steeve can be discharged. He ordered medications to be taken at home. The client is still weak and symptomatic, which of the following rights could be violated in this case? Right to _______.
- A. Know hospital rules
- B. Refuse treatment
- C. Privacy
- D. Continuity of care
Correct Answer: B
Rationale: The right to refuse treatment is a fundamental patient right. In this case, the physician ordering medications for the client to take at home without the client's input or agreement could possibly violate the client's right to refuse treatment. It is important for patients to have the autonomy to make decisions regarding their own treatment, especially when they are still weak and symptomatic. Patients should have the opportunity to discuss their treatment plan with their healthcare provider and express any concerns or preferences they may have.
A patient with a history of chronic obstructive pulmonary disease (COPD) is prescribed prednisone for an acute exacerbation. Which instruction is important for the nurse to include in patient education about prednisone therapy?
- A. "Take prednisone with antacids to minimize gastrointestinal upset."
- B. "Avoid abruptly stopping prednisone therapy."
- C. "Increase your intake of potassium-rich foods while taking prednisone."
- D. "Prednisone may cause weight loss, so monitor your weight regularly."
Correct Answer: B
Rationale: It is crucial for patients with COPD who are prescribed prednisone to be educated about the importance of not abruptly stopping the medication. Prednisone is a type of corticosteroid that should be tapered off gradually under the guidance of a healthcare provider to prevent potential withdrawal symptoms and adrenal insufficiency. Suddenly stopping prednisone can lead to serious adverse effects, including fatigue, weakness, joint pain, fever, dizziness, and potentially life-threatening complications. Therefore, adherence to the prescribed tapering schedule is essential to ensure the safe and effective management of COPD exacerbations with prednisone therapy.
A patient presents with polyuria, polydipsia, and polyphagia. Laboratory tests reveal hyperglycemia and glycosuria. Which endocrine disorder is most likely responsible for these symptoms?
- A. Hyperthyroidism
- B. Hypothyroidism
- C. Diabetes mellitus
- D. Cushing's syndrome
Correct Answer: C
Rationale: The symptoms of polyuria (excessive urination), polydipsia (excessive thirst), and polyphagia (excessive hunger) are classic signs of diabetes mellitus. In this case, the presence of hyperglycemia (high blood sugar) and glycosuria (glucose in the urine) further support the diagnosis of diabetes mellitus. Insulin deficiency or resistance in diabetes leads to impaired glucose utilization and excessive glucose in the bloodstream, causing the classic symptoms observed in the patient. Hyperthyroidism, hypothyroidism, and Cushing's syndrome do not typically present with the hallmark symptoms of polyuria, polydipsia, and polyphagia associated with uncontrolled diabetes mellitus.