Nokea
Angiotensin-converting enzyme (ACE) inhibitors may be prescribed for the client with diabetes mellitus to reduce vascular changes and possibly prevent or delay the development of:
- A. Chronic obstructive pulmonary disease (COPD).
- B. Pancreatic cancer.
- C. Renal failure.
- D. Cerebrovascular accident.
Correct Answer: C
Rationale: The correct answer is C: Renal failure. ACE inhibitors are commonly used in clients with diabetes mellitus to help reduce the progression of diabetic nephropathy by improving renal blood flow. This medication class can help prevent or delay the development of renal failure in these clients. Choices A, B, and D are incorrect because ACE inhibitors do not have a direct impact on preventing or delaying the development of chronic obstructive pulmonary disease, pancreatic cancer, or cerebrovascular accidents in clients with diabetes mellitus.
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The healthcare provider provides dietary instructions about iron-rich food to a client with iron deficiency anemia. Which food selection made by the client indicates a need for additional instructions?
- A. Liver
- B. Kidney beans
- C. Oranges
- D. Leafy green vegetables
Correct Answer: C
Rationale: Oranges are not a good source of iron, so selecting oranges indicates a need for additional instructions. Oranges are high in vitamin C, which can enhance iron absorption from other sources, but they are not rich in iron themselves. Liver, kidney beans, and leafy green vegetables are good sources of iron and would be beneficial for a client with iron deficiency anemia. Therefore, the correct answer is C.
Which of the following interventions is most appropriate for a patient with left-sided heart failure?
- A. Administering IV fluids.
- B. Administering oxygen.
- C. Administering diuretics.
- D. Administering antihypertensives.
Correct Answer: B
Rationale: Administering oxygen is the most appropriate intervention for a patient with left-sided heart failure because it helps improve oxygenation. In left-sided heart failure, the heart struggles to pump oxygen-rich blood to the body, leading to inadequate oxygen supply to tissues. Administering oxygen can help alleviate symptoms of hypoxia and reduce the workload on the heart. IV fluids (Choice A) may exacerbate heart failure by increasing fluid volume, diuretics (Choice C) are used to reduce fluid overload in heart failure, and antihypertensives (Choice D) are more suitable for managing hypertension, which may be a comorbidity in heart failure but are not the primary intervention for left-sided heart failure.
The client with chronic renal failure is receiving hemodialysis. Which of the following laboratory values should the nurse monitor closely?
- A. Hemoglobin level.
- B. Blood urea nitrogen (BUN) level.
- C. Serum potassium level.
- D. Creatinine level.
Correct Answer: C
Rationale: The serum potassium level should be monitored closely in clients undergoing hemodialysis due to the risk of hyperkalemia. Hemodialysis is used to remove waste products and excess electrolytes like potassium from the blood. Monitoring potassium levels is crucial because an imbalance can lead to serious cardiac complications, making it the priority value to monitor in this scenario. Monitoring hemoglobin levels (choice A) is important for anemia assessment in chronic renal failure but is not directly related to hemodialysis. Blood urea nitrogen (BUN) levels (choice B) and creatinine levels (choice D) are commonly monitored in renal function tests but are not the top priority for monitoring in a client undergoing hemodialysis.
The healthcare provider is assessing a client with chronic renal failure who is receiving hemodialysis. Which of the following findings would indicate a complication of the treatment?
- A. Temperature of 98.6°F (37°C).
- B. Weight gain of 2 lbs (0.9 kg) since the last treatment.
- C. Blood pressure of 130/80 mm Hg.
- D. Pulse rate of 72 bpm.
Correct Answer: B
Rationale: Weight gain between dialysis sessions can indicate fluid overload, a common complication in clients with chronic renal failure. This can lead to complications such as hypertension, pulmonary edema, and heart failure. A normal temperature, blood pressure, and pulse rate are expected findings in this scenario and would not typically indicate a complication of hemodialysis treatment.
In a patient with chronic kidney disease, which of the following is a common complication?
- A. Hyperkalemia.
- B. Hypernatremia.
- C. Hypocalcemia.
- D. Hyperphosphatemia.
Correct Answer: A
Rationale: Hyperkalemia is a common complication in chronic kidney disease due to the kidneys' reduced ability to excrete potassium. As kidney function declines, potassium levels may increase, leading to hyperkalemia. Hypernatremia (increased sodium levels), hypocalcemia (low calcium levels), and hyperphosphatemia (elevated phosphate levels) are not typically associated with chronic kidney disease. Therefore, the correct answer is hyperkalemia.