Nokea
The client's serum potassium level is elevated in acute renal failure, and the nurse administers sodium polystyrene sulfonate (Kayexalate). This drug acts to:
- A. Increase potassium excretion from the colon.
- B. Release hydrogen ions for sodium ions.
- C. Increase calcium absorption in the colon.
- D. Exchange sodium for potassium ions in the colon.
Correct Answer: D
Rationale: Kayexalate exchanges sodium for potassium in the colon, reducing serum potassium levels in acute renal failure.
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A nurse is providing postmortem care for a client who has died of cancer. The most appropriate action is to:
- A. Remove all medical equipment immediately.
- B. Leave the body uncovered for family viewing.
- C. Bathe the body and position it respectfully.
- D. Notify the family to collect belongings quickly.
Correct Answer: C
Rationale: Bathing and positioning the body respectfully prepares it for family viewing and honors the deceased, aligning with postmortem care standards.
A client's serum ammonia level is elevated, and the physician orders 30 mL of lactulose (Cephulac). Which of the following is an adverse effect of this drug?
- A. Increased urine output.
- B. Improved level of consciousness.
- C. Increased bowel movements.
- D. Nausea and vomiting.
Correct Answer: C
Rationale: Lactulose promotes bowel movements (C) to excrete ammonia, a common adverse effect. Urine output (A) and consciousness (B) are not adverse effects. Nausea (D) is less common.
A client post-lithotripsy asks about expected symptoms. The nurse should explain:
- A. Bruising at the site.
- B. Severe flank pain.
- C. Clear urine output.
- D. Fever above 102°F.
Correct Answer: A
Rationale: Bruising is common post-lithotripsy due to shock wave impact on tissues.
The nurse is precepting a newly hired nurse administering an intramuscular injection to an adult. Which action by the newly hired nurse requires follow-up?
- A. Prepares to administer the medication in the dorsogluteal.
- B. Prepares to insert the needle at a 90-degree angle.
- C. Uses isopropyl alcohol to clean the area prior to injection.
- D. Washes their hands before and after the procedure.
Correct Answer: A
Rationale: The dorsogluteal site is not recommended due to the risk of sciatic nerve injury.
A female client diagnosed with lung cancer is to have a left lower lobectomy. Which of the following increase the client's risk of developing postoperative pulmonary complications?
- A. Height is 5 feet, 7 inches and weight is 110 lb.
- B. The client tends to keep her real feelings to herself.
- C. 8.88 stimulates and can climb one flight of stairs without dyspnea.
- D. The client is 58 years of age.
Correct Answer: A
Rationale: Low body weight (5'7€, 110 lb) indicates malnutrition, increasing the risk of postoperative pulmonary complications due to weakened respiratory muscles. Emotional suppression, good exercise tolerance, and age 58 are less directly related.