Nokea
The client has been prescribed lisinopril (Prinivil) to treat hypertension. The nurse should assess the client for which of the following electrolyte imbalances?
- A. Hyponatremia
- B. Hypocalcemia
- C. Hypocalcemia
- D. Hypermagnesemia
Correct Answer: A
Rationale: Lisinopril, an ACE inhibitor, can cause hyponatremia due to its effects on sodium excretion. Hypocalcemia and hypermagnesemia are not commonly associated with this medication.
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A client with chronic kidney disease is on a low-potassium diet. Which food should the nurse advise the client to avoid?
- A. Apples.
- B. Bananas.
- C. Cauliflower.
- D. White bread.
Correct Answer: B
Rationale: Bananas are high in potassium, which must be limited in chronic kidney disease to prevent hyperkalemia.
A client who is brought to the emergency department has experienced a burn covering greater than 25% of his total body surface area (TBSA). When reviewing the laboratory results drawn on the client, which value should the nurse most likely expect to note?
- A. Hematocrit 65% (0.65)
- B. Albumin 4.0 g/dL (40 g/L)
- C. Sodium 140 mEq/L (140 mmol/L)
- D. White blood cell (WBC) count 6000 mm^3 (6 x 10^9/L)
Correct Answer: A
Rationale: Extensive burns covering greater than 25% of the TBSA result in generalized body edema in both burned and nonburned tissues and a decrease in circulating intravascular blood volume. Hematocrit levels elevate in the first 24 hours after injury (the emergent phase) as a result of hemoconcentration from the loss of intravascular fluid. The normal hematocrit is 42 to 52% (0.42-0.52) in the male and 37 to 47% (0.37-0.47) in the female. The normal albumin is 3.5-5 g/dL (35-50 g/L). The normal sodium level is 135 to 145 mEq/L (135-145 mmol/L). The normal WBC count is 5000 to 10,000 mm^3 (5-10 x 10^9/L).
The nurse is caring for a client with a history of Crohn's disease who is prescribed mesalamine (Asacol). The nurse should instruct the client to report which of the following side effects immediately?
- A. Mild diarrhea.
- B. Abdominal pain.
- C. Fever.
- D. Headache.
Correct Answer: C
Rationale: Fever may indicate an exacerbation of Crohn's disease or a side effect of mesalamine, requiring immediate reporting.
A client has cystitis. The nurse should further assess the client for:
- A. Flank pain.
- B. Oliguria.
- C. Nausea and vomiting.
- D. Foul-smelling urine.
Correct Answer: D
Rationale: Foul-smelling urine is a common symptom of cystitis due to bacterial infection. Flank pain and oliguria are more indicative of pyelonephritis.
The nurse is counseling a client regarding treatment of the client's newly diagnosed depression. The nurse emphasizes that full benefit from antidepressant therapy usually takes how long?
- A. 1 week
- B. 2 to 4 weeks
- C. 5 to 7 weeks
- D. 8 weeks
Correct Answer: B
Rationale: Antidepressants typically take 2 to 4 weeks to achieve full therapeutic effect, as they require time to adjust neurotransmitter levels. Other timeframes are too short or overly prolonged.