Nokea
The client with chronic renal failure is being educated about the importance of a low-sodium diet. Which of the following statements by the client indicates a need for further teaching?
- A. I can eat canned vegetables as long as I rinse them first.
- B. I can use table salt sparingly.
- C. I can eat frozen dinners if they are labeled low-sodium.
- D. I can eat whatever I want as long as I avoid salty foods.
Correct Answer: B
Rationale: The correct answer is B. Clients with chronic renal failure need to strictly limit their sodium intake. Advising the client to use table salt sparingly is incorrect as they should avoid table salt altogether to adhere to a low-sodium diet. Choice A is correct as rinsing canned vegetables can help reduce their sodium content. Choice C is correct as consuming frozen dinners labeled low-sodium can be a suitable option. Choice D is incorrect as it implies that avoiding only salty foods is sufficient, when in fact, overall sodium intake needs to be monitored closely.
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In a patient with cirrhosis, which of the following lab results is most concerning?
- A. Elevated liver enzymes.
- B. Low albumin levels.
- C. Elevated bilirubin levels.
- D. Low platelet count.
Correct Answer: D
Rationale: In a patient with cirrhosis, a low platelet count is the most concerning lab result. Thrombocytopenia, or low platelet count, is common in cirrhosis due to impaired platelet production in the liver. It significantly increases the risk of bleeding and can lead to serious complications such as hemorrhage. Elevated liver enzymes (Choice A) are expected in cirrhosis but may not directly indicate the severity of the disease. Low albumin levels (Choice B) are common in cirrhosis and can contribute to fluid retention but do not pose an immediate risk of bleeding. Elevated bilirubin levels (Choice C) are also expected in cirrhosis and typically indicate impaired liver function but do not directly increase the risk of bleeding as much as a low platelet count.
What is the primary purpose of administering anticoagulants to a patient with atrial fibrillation?
- A. To reduce blood pressure.
- B. To prevent clot formation.
- C. To prevent arrhythmias.
- D. To reduce inflammation.
Correct Answer: B
Rationale: The primary purpose of administering anticoagulants to a patient with atrial fibrillation is to prevent clot formation. Patients with atrial fibrillation are at an increased risk of forming blood clots in the heart, which can lead to stroke if they travel to the brain. Anticoagulants help to reduce this risk by inhibiting the clotting process. Therefore, choices A, C, and D are incorrect because anticoagulants do not primarily aim to reduce blood pressure, prevent arrhythmias, or reduce inflammation in patients with atrial fibrillation.
Which of the following lipid abnormalities is a risk factor for the development of atherosclerosis and peripheral vascular disease?
- A. Low concentration of triglycerides.
- B. High levels of high-density lipoprotein (HDL) cholesterol.
- C. High levels of low-density lipoprotein (LDL) cholesterol.
- D. Low levels of LDL cholesterol.
Correct Answer: C
Rationale: The correct answer is C: High levels of low-density lipoprotein (LDL) cholesterol. High levels of LDL cholesterol contribute to the development of atherosclerosis and peripheral vascular disease by being deposited in the blood vessel walls, leading to the formation of plaques that can obstruct blood flow. Choice A is incorrect as a low concentration of triglycerides is not typically associated with an increased risk of atherosclerosis or PVD. Choice B is incorrect as high levels of high-density lipoprotein (HDL) cholesterol are actually considered protective against atherosclerosis as it helps remove cholesterol from arteries. Choice D is incorrect as low levels of LDL cholesterol are not typically considered a risk factor for atherosclerosis or PVD.
A young adult is burned when wearing a shirt that was splashed with lighter fluid and caught on fire while attempting to light a charcoal grill. The client ripped off the shirt immediately, without unbuttoning the sleeves, which caused circumferential burns to both wrists. When the client is admitted, which intervention should the nurse implement first?
- A. Monitor pulse intensity.
- B. Evaluate extremity sensation.
- C. Assess range of motion.
- D. Place sterile bandage on both wrists.
Correct Answer: A
Rationale: Monitoring pulse intensity is the priority to ensure circulation is not compromised due to circumferential burns.
Which instruction should be included in the discharge teaching plan for a client who underwent cataract extraction today?
- A. Use a metal eye shield on the operative eye during the day.
- B. Administer eye ointment before applying eye drops.
- C. Sexual activities may be resumed after returning home.
- D. Light housekeeping is safe to do, but avoid heavy lifting.
Correct Answer: D
Rationale: The correct instruction to include in the discharge teaching plan for a client who underwent cataract extraction is to advise them that light housekeeping is safe to do, but they should avoid heavy lifting. Heavy lifting can strain the surgical site and potentially lead to complications. Choice A is incorrect as a metal eye shield is usually recommended during sleep, not during the day. Choice B is incorrect because eye ointment should typically be administered after applying eye drops to prevent dilution of the medication. Choice C is incorrect as sexual activities should usually be avoided for a specific period post-surgery as advised by the healthcare provider.