Nokea
A patient with a diagnosis of bipolar disorder has been drinking copious amounts of water and voiding frequently. The patient is experiencing muscle cramps, twitching, and is reporting dizziness.
The nurse checks lab work for
- A. complete blood count results, particularly the platelets.
- B. electrolytes, particularly the serum sodium.
- C. urine analysis, particularly for the presence of white blood cells.
- D. EEG.
Correct Answer: B
Rationale: Symptoms suggest hyponatremia from excessive water intake, requiring electrolyte assessment.
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The patient with hypothyroidism
The patient with hypothyroidism will most likely experience which of the following?
- A. Diarrhea and weight gain.
- B. Warm skin and brittle nails.
- C. Dry skin and weight gain.
- D. Constipation and tachycardia.
Correct Answer: C
Rationale: Hypothyroidism causes dry skin and weight gain due to slowed metabolism.
An 82-year-old woman who has Alzheimer's disease is admitted to the acute care unit. She frequently gets out of bed and wanders in the hall, unable to find her way back to her room. She even gets in the beds of other clients. What nursing action is most appropriate for this client?
- A. Restrain her so she will not wander in the halls
- B. Ask her roommate to call the nurse whenever she leaves the room
- C. Punish her when she gets in a bed other than her own
- D. Put her favorite picture on the door to her room
Correct Answer: D
Rationale: A familiar picture on the door helps the Alzheimer's client recognize her room, reducing wandering safely. Restraints, roommate monitoring, or punishment are inappropriate or ineffective.
Epoetin alfa (Epogen) is prescribed for a client who is on dialysis. When teaching the client about the drug, the nurse should plan to include which information about the drug?
- A. The drug is given to help the kidneys produce urine.
- B. The drug is given because the kidneys can no longer get rid of waste products.
- C. The drug replaces natural erythropoietin, which can no longer be produced when the kidney is in failure.
- D. The drug is given to the client to improve athletic ability.
Correct Answer: C
Rationale: Epoetin alfa replaces erythropoietin, deficient in kidney failure, to stimulate red blood cell production, correcting anemia. It does not affect urine production, waste removal, or athletic performance.
A new mother has some questions about PKU.
Which of the following statements made by the nurse is correct regarding PKU?
- A. An amniocentesis is required prior to delivery.
- B. PKU test is performed soon after birth.
- C. PKU is preventable if the mother eats adequate amount of protein during pregnancy.
- D. The effects of PKU are irreversible
Correct Answer: B
Rationale: The PKU test is performed shortly after birth to detect phenylalanine levels.
After a painful exacerbation of rheumatoid arthritis, a patient is to begin a walking and exercise program.
An appropriate outcome would be that the patient:
- A. Avoids exercising when there is some discomfort.
- B. Is pain free while engaging in the activity program.
- C. Walks and exercise even when the pain is severe.
- D. Exercise unless the discomfort becomes too great.
Correct Answer: D
Rationale: Exercising until discomfort becomes too great balances activity with joint protection, promoting safe participation.