Nokea
The nurse cares for a client receiving fludrocortisone acetate for the treatment of Addison's disease. When monitoring the client for improvement, what anticipated therapeutic effect of this medication will the nurse focus on?
- A. Promote electrolyte balance.
- B. Stimulate thyroid production.
- C. Stimulate the immune response.
- D. Stimulate thyrotropin production.
Correct Answer: A
Rationale: Fludrocortisone acetate is a long-acting oral medication with mineralocorticoid and moderate glucocorticoid activity that may be used for long-term management of Addison's disease. Mineralocorticoids act on the renal distal tubules to enhance the reabsorption of sodium and chloride ions and the excretion of potassium and hydrogen ions. The client can rapidly develop hypotension and fluid and electrolyte imbalance if the medication is discontinued abruptly. The medication does not affect the immune response or thyroid or thyrotropin production.
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An infant is at risk for an ileus after surgery to correct intussusception. Which observation should the nurse not include in an assessment for this complication?
- A. Measurement of urine specific gravity.
- B. Assessment of bowel sounds.
- C. Characteristics of the first stool.
- D. Measurement of gastric output.
Correct Answer: A
Rationale: Urine specific gravity is unrelated to assessing for ileus, which involves monitoring bowel sounds, stool characteristics, and gastric output to detect gastrointestinal function.
A client with a history of chronic kidney disease is prescribed darbepoetin alfa (Aranesp). The nurse should monitor the client for which of the following side effects?
- A. Hypotension.
- B. Hypertension.
- C. Hypoglycemia.
- D. Weight loss.
Correct Answer: B
Rationale: Darbepoetin alfa can cause hypertension due to increased red blood cell production, requiring monitoring.
The nurse is admitting a client with a diagnosis of Guillain-Barre syndrome. During the history taking, the nurse should ask if the client has recently experienced which physical problem?
- A. Meningitis
- B. Seizures or head trauma
- C. A back injury or spinal cord trauma
- D. A respiratory or gastrointestinal (GI) infection
Correct Answer: D
Rationale: Guillain-Barre syndrome is a clinical condition of unknown origin that involves cranial and peripheral nerves. Many clients report a history of respiratory or GI infection in the 1 to 4 weeks before the onset of neurological deficits. Occasionally it has been triggered by vaccination or surgery. The other options are not associated with an incidence of this syndrome.
The nurse is teaching a community group about violence in the family. Which statement by a group member about abusers would indicate a need for further teaching?
- A. They use fear and intimidation.
- B. They usually have poor self-esteem.
- C. They are often jealous or self-centered.
- D. They are more often from low-income families.
Correct Answer: D
Rationale: Personal characteristics of abusers include low self-esteem, immaturity, dependence, insecurity, and jealousy. The statement that abusers are more common among low-income families is inaccurate. The remaining options do describe characteristics of abusers who often use fear and intimidation to the point where their victims will do anything just to avoid further abuse.
The nurse assesses a client and notes that he has a weak, irregular pulse, as well as soft, flabby muscles. The nurse should assess the client further for:
- A. Hypercalcemia.
- B. Hypernatremia.
- C. Hypokalemia.
- D. Hypomagnesemia.
Correct Answer: C
Rationale: Weak, irregular pulse and flabby muscles are signs of hypokalemia, which affects muscle and cardiac function. The other conditions present differently.