Nokea
The client with chronic kidney disease (CKD) is being taught about the necessary sodium restriction in the diet to prevent edema and hypertension. Which statement by the client indicates more teaching is needed?
- A. I am thrilled that I can continue to eat fast food.
- B. I will cut out bacon with my eggs every morning.
- C. My cooking style will change by not adding salt.
- D. I will probably lose weight by cutting out potato chips.
Correct Answer: A
Rationale: Choice A, 'I am thrilled that I can continue to eat fast food,' indicates a lack of understanding as fast food is typically high in sodium, which is detrimental for individuals with CKD. The client should be advised to avoid fast food due to its high sodium content. Choices B, C, and D demonstrate a good understanding of the need for sodium restriction in the diet to prevent complications associated with CKD. Cutting out bacon, avoiding salt in cooking, and eliminating high-sodium snacks like potato chips are all positive steps towards managing CKD.
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What information will the nurse provide when counseling a patient starting a sulfonamide drug for a urinary tract infection?
- A. Drink several quarts of water daily.
- B. If stomach upset occurs, avoid taking antacids.
- C. Limit sun exposure to avoid skin reactions.
- D. Report any sore throat promptly.
Correct Answer: A
Rationale: The correct answer is A: Drink several quarts of water daily. This advice aims to prevent crystalluria, a potential side effect of sulfonamide drugs. Option B is incorrect because antacids should not be taken with sulfonamides as they can decrease drug absorption. Option C is incorrect as sulfonamides can increase sensitivity to sunlight, not requiring sun exposure limitations but sun protection measures. Option D is incorrect because a sore throat could indicate a more serious adverse effect and should be promptly reported for evaluation.
The patient will take a high dose of azithromycin after discharge from the hospital. Which statement by the patient indicates understanding of the teaching?
- A. I may take antacids 2 hours before taking this drug.
- B. I should take acetaminophen for fever or mild pain.
- C. I should expect diarrhea to be a common, mild side effect.
- D. I should avoid dairy products while taking this drug.
Correct Answer: A
Rationale: The correct answer is A. Azithromycin peak levels may be reduced by antacids when taken at the same time, so patients should be cautioned to take antacids 2 hours before or 2 hours after taking the drug. Choice B is incorrect because high-dose azithromycin carries a risk for hepatotoxicity when taken with other potentially hepatotoxic drugs such as acetaminophen. Choice C is incorrect as diarrhea may indicate pseudomembranous colitis and should be reported, not expected as a common mild side effect. Choice D is incorrect; there is no restriction for dairy products while taking azithromycin.
An emergency department nurse assesses a client with a history of urinary incontinence who presents with extreme dry mouth, constipation, and an inability to void. Which question should the nurse ask first?
- A. Are you drinking plenty of water?
- B. What medications are you taking?
- C. Have you tried laxatives or enemas?
- D. Has this type of thing ever happened before?
Correct Answer: B
Rationale: In this scenario, the client's symptoms of dry mouth, constipation, and inability to void are indicative of anticholinergic side effects, which can be caused by medications like propantheline (Pro-Banthine) commonly used to treat incontinence. The first question the nurse should ask is about the client's medications to determine if they are taking anticholinergic drugs. This information is crucial as it can help differentiate between a simple side effect or a potential overdose. Asking about water intake (Choice A) may be relevant later but is not the priority in this situation. Questioning about laxatives or enemas (Choice C) and past occurrences (Choice D) are not as pertinent initially as identifying the client's current medication status.
A pregnant client tells the nurse, "I am experiencing a burning pain when I urinate." How should the nurse respond?
- A. This means labor will start soon. Prepare to go to the hospital.
- B. You probably have a urinary tract infection. Drink more cranberry juice.
- C. Make an appointment with your provider to have your infection treated.
- D. Your pelvic wall is weakening. Pelvic muscle exercises should help.
Correct Answer: C
Rationale: Pregnant clients with a urinary tract infection require prompt and aggressive treatment because cystitis can lead to acute pyelonephritis during pregnancy. The nurse should encourage the client to make an appointment and have the infection treated. Burning pain when urinating does not indicate the start of labor or weakening of pelvic muscles. Choice A is incorrect because burning pain during urination does not signify the start of labor. Choice B is incorrect because while cranberry juice may help prevent urinary tract infections, it is not a treatment. Choice D is incorrect because burning pain when urinating is not indicative of weakening pelvic muscles.
A client with histoplasmosis has the following arterial blood gas (ABG) results: pH 7.30, PCO2 58 mm Hg, PO2 75 mm Hg, HCO3 27 mEq/L. Which of the following acid-base disturbances does the nurse recognize in these results?
- A. Metabolic acidosis
- B. Metabolic alkalosis
- C. Respiratory acidosis
- D. Respiratory alkalosis
Correct Answer: A
Rationale: The client's ABG results show a low pH (acidosis) and an elevated PCO2, indicating respiratory acidosis. In respiratory acidosis, there is inadequate excretion of CO2, leading to increased PCO2 levels and a decrease in pH. Therefore, the correct answer is 'Metabolic acidosis'. Choices B, C, and D are incorrect. Metabolic alkalosis is characterized by elevated pH and bicarbonate levels. Respiratory acidosis involves low pH and high PCO2 levels, as seen in this case. Respiratory alkalosis is associated with high pH and low PCO2 levels.