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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Which of the following is a key symptom of myocardial infarction (MI)?
- A. Chest pain.
- B. Shortness of breath.
- C. Nausea.
- D. Fatigue.
Correct Answer: A
Rationale: The correct answer is A: Chest pain. Chest pain is a hallmark symptom of myocardial infarction (MI) due to inadequate blood flow to the heart muscle. This pain can be severe, crushing, or squeezing, and may radiate to the left arm, jaw, or back. Shortness of breath (choice B), nausea (choice C), and fatigue (choice D) can accompany MI but are not as specific or characteristic as chest pain in diagnosing this condition. Therefore, chest pain is the primary symptom to recognize for suspected MI.
A client with chronic renal failure is receiving erythropoietin therapy. The nurse should assess the client for which of the following side effects?
- A. Hypotension.
- B. Hypertension.
- C. Hyperglycemia.
- D. Hypercalcemia.
Correct Answer: B
Rationale: The correct answer is B: Hypertension. Erythropoietin therapy can lead to an increase in blood pressure, making hypertension a common side effect that the nurse should closely monitor. Hypotension (choice A) is not typically associated with erythropoietin therapy. Hyperglycemia (choice C) and hypercalcemia (choice D) are not commonly linked to erythropoietin therapy in clients with chronic renal failure, making them incorrect choices.
During a routine clinic visit, a nurse is assessing a 48-year-old client with a history of smoking. The client, who exercises regularly, reports calf pain during exercise that disappears at rest. Which of the following findings requires further evaluation?
- A. Heart rate of 57 bpm.
- B. SpO2 of 94% on room air.
- C. Blood pressure of 134/82.
- D. Ankle-brachial index of 0.65.
Correct Answer: D
Rationale: An Ankle-Brachial Index of 0.65 suggests moderate arterial vascular disease in a client experiencing intermittent claudication, indicating compromised blood flow to the lower extremities during exercise. This finding requires further evaluation to assess the severity of arterial insufficiency and determine appropriate interventions.
Choice A (Heart rate of 57 bpm) is within the normal range for an adult at rest and indicates good cardiovascular fitness. Choice B (SpO2 of 94% on room air) is slightly lower than the normal range but is generally acceptable in a healthy individual. Choice C (Blood pressure of 134/82) falls within the normal range and does not raise immediate concerns in this context.
The client with chronic renal failure asks why a low-protein diet is necessary. Which of the following is the best response by the nurse?
- A. It reduces the workload on your kidneys.
- B. It helps prevent the buildup of waste products.
- C. It helps maintain electrolyte balance in your body.
- D. It helps prevent dehydration.
Correct Answer: B
Rationale: A low-protein diet is necessary for clients with chronic renal failure to help prevent the buildup of waste products, such as urea, in the body. Choice A is incorrect as the primary reason for a low-protein diet is to manage waste product accumulation rather than reducing the workload on the kidneys. Choice C is incorrect as electrolyte balance is typically managed through dietary restrictions beyond protein intake. Choice D is incorrect as preventing dehydration is not the primary purpose of a low-protein diet in chronic renal failure.
The client with chronic renal failure who is on a low-sodium diet should avoid which of the following foods?
- A. Fresh fruits.
- B. Canned soups.
- C. Lean meats.
- D. Whole grain bread.
Correct Answer: B
Rationale: Canned soups are high in sodium, which can lead to fluid retention and hypertension in clients with chronic renal failure who are on a low-sodium diet. Fresh fruits, lean meats, and whole grain bread are generally lower in sodium and can be included in a low-sodium diet. Lean meats provide essential protein, fresh fruits offer vitamins and minerals, and whole grain bread provides fiber, making them suitable choices for individuals with chronic renal failure.