Nokea
The nurse empties the nasogastric suction collection canister of a client who had a bowel resection the previous day and notes that 1000 ml of gastric secretions were collected in the last 4 hours. What condition is the client at risk for developing?
- A. Metabolic alkalosis
- B. Hyperkalemia
- C. Metabolic acidosis
- D. Hypoglycemia
Correct Answer: A
Rationale: The correct answer is A: Metabolic alkalosis. Loss of gastric secretions, which contain stomach acid, can lead to metabolic alkalosis. Excessive loss of acid results in an increase in the blood pH, leading to alkalosis. Hyperkalemia (B) is an elevated potassium level and is not directly related to the loss of gastric secretions. Metabolic acidosis (C) is an acid-base imbalance characterized by low pH and bicarbonate levels, which is the opposite of what would occur with the loss of gastric secretions. Hypoglycemia (D) is low blood sugar and is not typically associated with the scenario described in the question.
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The client with chronic renal failure is being taught about dietary restrictions by the nurse. Which of the following food items should the client avoid?
- A. Apples
- B. Bananas
- C. Chicken
- D. Rice
Correct Answer: B
Rationale: The correct answer is B: Bananas. Bananas are high in potassium, which should be limited in clients with chronic renal failure to prevent hyperkalemia. Apples (choice A), chicken (choice C), and rice (choice D) are not typically restricted in clients with chronic renal failure. Apples and rice are lower in potassium, while chicken is a good source of lean protein, which is usually encouraged in these clients to meet their protein needs without excess potassium intake.
What is the most common cause of urinary tract infections (UTIs)?
- A. Escherichia coli infection
- B. Staphylococcus aureus infection
- C. Pseudomonas aeruginosa infection
- D. Klebsiella pneumoniae infection
Correct Answer: A
Rationale: Escherichia coli is the most common cause of urinary tract infections (UTIs). It is responsible for the majority of UTIs, especially in women. E. coli is a normal inhabitant of the bowel and can enter the urinary tract through the urethra, leading to infection. Staphylococcus aureus, Pseudomonas aeruginosa, and Klebsiella pneumoniae are less common causes of UTIs compared to E. coli. Staphylococcus aureus typically causes skin and soft tissue infections, Pseudomonas aeruginosa is more commonly associated with healthcare-associated infections, and Klebsiella pneumoniae is known for causing pneumonia and other respiratory infections.
A patient presents with severe chest pain radiating to the left arm. Which of the following diagnostic tests is the priority?
- A. Complete blood count (CBC)
- B. Electrocardiogram (ECG)
- C. Chest X-ray
- D. Serum electrolytes
Correct Answer: B
Rationale: In a patient presenting with severe chest pain radiating to the left arm, the priority diagnostic test is an Electrocardiogram (ECG) to assess for myocardial infarction. An ECG can quickly identify changes indicative of ischemia or infarction, guiding prompt management. A Complete Blood Count (CBC) may provide some information but is not the primary test for evaluating chest pain related to myocardial infarction. A Chest X-ray can be useful in assessing lung pathologies or certain cardiac conditions; however, it does not provide immediate information on myocardial infarction, making it a secondary option in this scenario. Serum electrolytes may become important in later stages but do not offer immediate insights into myocardial infarction. Therefore, they are a lower priority compared to obtaining an ECG for timely diagnosis and intervention.
A client with chronic renal failure is receiving calcium acetate (PhosLo). The nurse should monitor the client for which of the following side effects?
- A. Hypercalcemia.
- B. Hypocalcemia.
- C. Hyperglycemia.
- D. Hypoglycemia.
Correct Answer: A
Rationale: Corrected Question: A client with chronic renal failure is receiving calcium acetate (PhosLo). The nurse should monitor the client for which of the following side effects?
Rationale: The correct answer is A, Hypercalcemia. Calcium acetate (PhosLo) is a medication used to lower phosphate levels in patients with chronic renal failure. It works by binding with dietary phosphate and preventing its absorption. However, this can lead to an excess of calcium in the blood, causing hypercalcemia. Therefore, the nurse should closely monitor the client for signs and symptoms of elevated calcium levels, such as nausea, vomiting, confusion, and muscle weakness. Choices B, C, and D are incorrect as calcium acetate does not typically cause hypocalcemia, hyperglycemia, or hypoglycemia.
Which of the following interventions is most appropriate for a patient with acute pancreatitis?
- A. Administering oral fluids.
- B. Administering IV fluids.
- C. Administering analgesics.
- D. Encouraging the patient to ambulate.
Correct Answer: B
Rationale: The most appropriate intervention for a patient with acute pancreatitis is administering IV fluids. IV fluid administration is crucial in managing acute pancreatitis as it helps maintain hydration, correct electrolyte imbalances, and prevent shock. Administering oral fluids (Choice A) may not be sufficient to address the fluid loss and maintain hydration in these patients. While analgesics (Choice C) are important for pain management in pancreatitis, addressing hydration and shock prevention takes precedence. Encouraging the patient to ambulate (Choice D) may be beneficial in some cases for preventing complications like deep vein thrombosis, but it is not the primary intervention needed in the acute phase of pancreatitis.