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The client with a history of gout is prescribed allopurinol (Zyloprim). The nurse should instruct the client to:
- A. Limit fluid intake to prevent urinary complications.
- B. Take the medication with a full glass of water.
- C. Avoid foods high in calcium.
- D. Take the medication on an empty stomach.
Correct Answer: B
Rationale: Allopurinol reduces uric acid production, and taking it with a full glass of water promotes excretion of uric acid, preventing kidney stones. Fluid restriction is harmful, calcium is not restricted, and it can be taken with food.
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Which diet would the nurse expect to see ordered for a patient with nephrotic syndrome?
- A. Low carbohydrate potassium
- B. Moderate protein
- C. Low calcium
- D. Increased potassium
Correct Answer: B
Rationale: Nephrotic syndrome causes proteinuria, leading to hypoalbuminemia. A moderate protein diet (0.8–1 g/kg/day) helps replace lost protein without overloading the kidneys. Low carbohydrate, low calcium, or increased potassium diets are not specific to nephrotic syndrome.
The nurse is assessing a client following a coronary artery bypass graft (CABG). The nurse should give priority to reporting:
- A. Chest drainage of 150 mL in the past hour
- B. Confusion and restlessness
- C. Pallor and coolness of skin
- D. Urinary output of 40 mL per hour
Correct Answer: A
Rationale: Chest drainage of 150 mL/hour post-CABG suggests significant bleeding, requiring immediate reporting to prevent hypovolemia. Confusion, pallor, and low urine output are less urgent.
A client is experiencing muscle weakness and lethargy. His serum K+ is 3.2. What other symptoms might he exhibit?
- A. Tetany
- B. Dysrhythmias
- C. Numbness of extremities
- D. Headache
Correct Answer: B
Rationale: Low potassium (3.2) causes dysrhythmias due to its role in cardiac muscle activity. The other symptoms are not associated with hypokalemia.
The nurse is teaching a client with a history of lactose intolerance about dietary modifications. The nurse should tell the client to avoid:
- A. Dairy products
- B. High-fiber foods
- C. Lean meats
- D. Fresh fruits
Correct Answer: A
Rationale: Dairy products contain lactose, which causes gastrointestinal symptoms in lactose intolerance, so they should be avoided.
A client develops a temperature of 102°F following coronary artery bypass surgery. The nurse should notify the physician immediately because elevations in temperature:
- A. Increase cardiac output
- B. Indicate cardiac tamponade
- C. Decrease cardiac output
- D. Indicate graft rejection
Correct Answer: C
Rationale: Fever post-CABG increases metabolic demand, potentially decreasing cardiac output in a compromised heart, requiring immediate attention. Tamponade and rejection have other signs.