Nokea
The client diagnosed with ARF is placed on bedrest. The client asks the nurse, 'Why do I have to stay in bed? I don’t feel bad.' Which scientific rationale supports the nurse’s response?
- A. Bedrest helps increase the blood return to the renal circulation.
- B. Bedrest reduces the metabolic rate during the acute stage.
- C. Bedrest decreases the workload of the left side of the heart.
- D. Bedrest aids in reduction of peripheral and sacral edema.
Correct Answer: B
Rationale: Bedrest reduces the body’s metabolic demands, minimizing stress on the kidneys during the acute phase of ARF. It does not directly increase renal blood flow, reduce heart workload, or address edema in this context.
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Which response by the nurse is best?
- A. Encourage the client to restrict fluid intake because it shows evidence of client cooperation.
- B. Encourage the client to restrict fluid intake because it leads to accomplishing the goal.
- C. Discourage the client from restricting fluid intake because it contributes to constipation.
- D. Discourage the client from restricting fluid intake because it potentiates fluid imbalance.
Correct Answer: D
Rationale: Restricting fluid intake can lead to dehydration and fluid imbalance, which can worsen health outcomes, so the nurse should discourage this action.
The female client diagnosed with bladder cancer who has a cutaneous urinary diversion states, 'Will I be able to have children now?' Which statement is the nurse’s best response?
- A. Cancer does not make you sterile, but sometimes the therapy can.'
- B. Are you concerned you can’t have children?'
- C. You will be able to have as many children as you want.'
- D. Let me have the chaplain come to talk with you about this.'
Correct Answer: A
Rationale: Bladder cancer itself does not cause sterility, but treatments (e.g., chemotherapy, radiation) may affect fertility. This response is accurate and informative. Reflecting concern, promising fertility, or referring to a chaplain avoids the question.
The client diagnosed with ARF is experiencing hyperkalemia. Which medication should the nurse prepare to administer to help decrease the potassium level?
- A. Erythropoietin.
- B. Calcium gluconate.
- C. Regular insulin.
- D. Osmotic diuretic.
Correct Answer: C
Rationale: Regular insulin, often given with glucose, drives potassium into cells, temporarily lowering serum potassium levels in hyperkalemia. Calcium gluconate stabilizes cardiac membranes, erythropoietin treats anemia, and osmotic diuretics are not used for hyperkalemia.
The client diagnosed with cancer of the bladder states, 'I have young children. I am too young to die.' Which statement is the nurse’s best response?
- A. This cancer is treatable and you should not give up.'
- B. Cancer occurs at any age. It is just one of those things.'
- C. You are afraid of dying and what will happen to your children.'
- D. Have you talked to your children about your dying?'
Correct Answer: C
Rationale: Reflecting the client’s fear of dying and concern for their children validates emotions and encourages dialogue. Reassurance, generalizing cancer, or prompting child discussions may dismiss the client’s feelings.
Which assessment supports the nurse's assumption that the client's sleep disturbance was most likely due to anxiety?
- A. The client was pacing the room before bedtime.
- B. The client's vital signs were stable during the night.
- C. The client requested a sleeping pill earlier.
- D. The client reported feeling rested in the morning.
Correct Answer: A
Rationale: Pacing before bedtime is a behavioral sign of anxiety, supporting the assumption that anxiety caused the sleep disturbance.