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The client with cirrhosis receives 100 mL of 25% serum albumin I.V. Which finding would best indicate that the albumin is having its desired effect?
- A. Increased urine output.
- B. Increased serum albumin level.
- C. Decreased anorexia.
- D. Increased ease of breathing.
Correct Answer: D
Rationale: Albumin increases oncotic pressure, reducing ascites and improving respiratory function. Increased ease of breathing (D) indicates effectiveness. Urine output (A), serum albumin (B), and anorexia (C) are less direct indicators.
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The nurse has been assigned to a client who is hearing impaired and reads speech. Which of the following strategies should the nurse incorporate when communicating with the client? Select all that apply.
- A. Avoiding being silhouetted against strong light.
- B. Not blocking out the person's view of the speaker's mouth.
- C. Facing the client when talking.
- D. Having bright light behind so the individual can see.
- E. Ensuring the client is familiar with the subject material before discussing.
- F. Talking to the client while doing other nursing procedures.
Correct Answer: A,B,C
Rationale: To facilitate lip-reading, the nurse should avoid strong backlighting, not block the view of the mouth, and face the client directly to ensure clear visibility of facial expressions and lips.
A nurse is caring for a client with lung cancer who develops syndrome of inappropriate antidiuretic hormone (SIADH). Which laboratory finding should the nurse expect?
- A. Serum sodium of 128 mEq/L.
- B. Serum potassium of 5.5 mEq/L.
- C. Serum calcium of 11.0 mg/dL.
- D. Serum glucose of 200 mg/dL.
Correct Answer: A
Rationale: SIADH causes water retention, diluting serum sodium, so a low sodium level (128 mEq/L) is expected due to the inappropriate secretion of antidiuretic hormone.
The client who does not respond adequately to fluid replacement has an order for an I.V. infusion of dopamine hydrochloride at 5 µg/kg/minute. To determine that the drug is having the desired effect, the nurse should assess the client for:
- A. Increased renal and mesenteric blood flow.
- B. Increased cardiac output.
- C. Vasoconstriction.
- D. Reduced preload and afterload.
Correct Answer: B
Rationale: Dopamine at 5 µg/kg/minute primarily increases cardiac output by enhancing myocardial contractility and heart rate, improving perfusion in shock. Renal/mesenteric flow occurs at lower doses, vasoconstriction at higher doses, and preload/afterload reduction is not a primary effect.
Galactorrhea is caused by overproduction of which hormone?
- A. Prolactin.
- B. Adrenocorticotropic hormone (ACTH).
- C. Growth hormone (GH).
- D. Thyroid-stimulating hormone (TSH).
Correct Answer: A
Rationale: Galactorrhea (inappropriate breast milk production) is caused by excess prolactin, often due to a prolactin-secreting pituitary adenoma.
The nurse is teaching a client with osteoarthritis about assistive devices. Which device is most appropriate for ambulation?
- A. Standard cane.
- B. Wheelchair.
- C. Four-wheeled walker.
- D. Crutches.
Correct Answer: A
Rationale: A standard cane provides support and stability for clients with osteoarthritis during ambulation.