Nokea
The nurse in the outpatient clinic is caring for a client with heart failure who reports increased ankle swelling and a 3-lb (1.4-kg) weight gain over the past 2 days. The nurse reviews the client's current medications and anticipates the need for an increase in the dosage of which of the following medications?
- A. Bumetanide
- B. Candesartan
- C. Carvedilol
- D. Isosorbide
Correct Answer: A
Rationale: A 3-lb weight gain and ankle swelling in heart failure indicate fluid retention, requiring an increased dose of a diuretic like bumetanide . Candesartan , carvedilol , and isosorbide manage other aspects but do not directly address acute fluid overload.
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Which of the following tasks can the practical nurse (PN) safely assign to an experienced unlicensed assistive personnel (UAP)? Select all that apply.
- A. Ambulate an oxygen-dependent client to the bathroom
- B. Check pulse oximetry for a client with respiratory rate 12/min
- C. Instruct a client with pneumonia on usage of the incentive spirometer
- D. Provide oral hygiene to a client with chronic obstructive pulmonary disease (COPD)
- E. Turn and reposition a client with pneumonia
Correct Answer: A,B,D,E
Rationale: UAP can ambulate stable clients , check pulse oximetry , provide oral hygiene , and reposition clients . Instructing on incentive spirometry requires nursing judgment and is not delegable.
A client with Cushing's syndrome should be instructed to:
- A. Avoid alcoholic beverages
- B. Limit the sodium in her diet
- C. Increase servings of dark green vegetables
- D. Limit the amount of protein in her diet
Correct Answer: B
Rationale: A client with Cushing's syndrome has adrenocortical hypersecretion, so she retains sodium and water. The client may drink alcohol in moderation, so answer A is incorrect, and there is no need to eat more green vegetables or limit protein, so answers C and D are incorrect.
Laboratory Reference Range
Glucose (fasting)
70-110 mg/dL
(3.9-6.1 mmol/L)
The nurse has received information from unlicensed assistive personnel about assigned client situations. Which of the following situations should the nurse address first?
- A. Client who has type 1 diabetes mellitus and a fasting capillary blood glucose level of 90 mg/dL (5.0 mmol/L)
- B. client who is collecting a 24-hour urine specimen and discarded the last void by mistake
- C. client who is requesting clarification about the diagnostic procedure that is scheduled to begin in 4 hours
- D. client who was recently admitted to a room that has a full sharps disposal container on the wall
Correct Answer: D
Rationale: A full sharps container poses an immediate safety hazard and must be addressed first. Normal glucose , a discarded void , and procedure clarification are less urgent.
A client is scheduled for a percutaneous transluminal coronary angioplasty (PTCA). The nurse knows that a PTCA is the
- A. Surgical repair of a diseased coronary artery
- B. Placement of an automatic internal cardiac defibrillator
- C. Procedure that compresses plaque against the wall of the diseased coronary artery to improve blood flow
- D. Non-invasive radiographic examination of the heart
Correct Answer: C
Rationale: PTCA is performed to improve coronary artery blood flow in a diseased artery. It is performed during a cardiac catheterization.
The nurse would expect the cystic fibrosis client to receive supplemental pancreatic enzymes along with a diet
- A. High in carbohydrates and proteins
- B. Low in carbohydrates and proteins
- C. High in carbohydrates, low in proteins
- D. Low in carbohydrates, high in proteins
Correct Answer: A
Rationale: High in carbohydrates and proteins. This diet supports energy needs and compensates for malabsorption in cystic fibrosis.