Nokea
In planning Mrs. Filbert's care during an acute attack of Meniere disease, it would be most important to
- A. encourage her to discuss her feelings about her illness
- B. keep her siderails up and provide assistance when she is permitted out of bed
- C. instruct her about prescribed dietary modifications
- D. encourage her to walk around her room so that her joints will not get stiff
Correct Answer: C
Rationale: Dietary changes, such as reducing salt intake, play a key role in managing Meniere disease by helping control fluid balance in the inner ear.
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Rob has a history of using ecstasy. He is exhibiting symptoms of hypotension, nausea, diarrhea, personality change, diminished level of consciousness, and decreased deep tendon reflexes. Laboratory results confirm the physician’s suspicion of hyponatremia. Treatment would include:
- A. Water restriction.
- B. 0.33% sodium chloride intravenously.
- C. Use of salt substitute.
- D. Calcium carbonate orally.
Correct Answer: A
Rationale: The correct answer is Water restriction (A). Hyponatremia is often caused by excess water retention relative to sodium levels. Restricting water intake helps restore the balance of sodium and water in the body.
Following chemotherapy, a patient is being closely monitored for tumor lysis syndrome. Which laboratory value requires particular attention?
- A. Platelet count.
- B. Electrolytes.
- C. Hemoglobin.
- D. Hematocrit.
Correct Answer: B
Rationale: Electrolyte imbalances, particularly hyperkalemia and hyperuricemia, are hallmark features of tumor lysis syndrome and must be closely monitored.
Paralytic ileus may occur as a postoperative complication. Which of the following patients would you be most concerned about the development of paralytic ileus?
- A. Kim, a 27-year-old postlaparoscopic appendectomy.
- B. Joyce, a 39-year-old post–open right hemicolectomy.
- C. Nancy, a 56-year-old postmediastinoscopy.
- D. John, a 47-year-old post–total joint replacement.
Correct Answer: B
Rationale: Paralytic ileus is more common after abdominal surgeries, particularly those involving bowel manipulation, such as an open right hemicolectomy. Joyce is at the highest risk due to the nature of her surgery.
What strategies could decrease the distress of rotating shifts for nurses (select all that apply)?
- A. Take a brief onsite nap
- B. Use sleep hygiene practices
- C. Sleep just before going to work
- D. Maintain consistent sleep/wake schedules even on days off (if possible)
Correct Answer: A
Rationale: The correct answers are A, B, and D. Brief naps (A), sleep hygiene (B), and consistent schedules (D) improve adaptation to shift work. Sleeping just before work (C) can worsen sleep quality.
The medical-surgical nurse, who cares for a patient newly diagnosed with cancer, observes the patient becoming angry with the physicians and nursing staff. The best approach to diffuse the emotionally charged discussion is to
- A. allow the patient and family members time to be alone.
- B. arrange time for the patient to speak with another patient with cancer.
- C. direct the discussion and validation of emotion, without false reassurance.
- D. request a consultation from a social worker on the oncology unit.
Correct Answer: C
Rationale: Validating emotions without dismissing them helps the patient process feelings.