Nokea
The nurse is administering sevelamer (RenaGel) during lunch to a client with end-stage renal disease (ESRD). The client asks the nurse to bring the medication later. The nurse should describe which action of RenaGel as an explanation for taking it with meals?
- A. Prevents indigestion associated with the ingestion of spicy foods.
- B. Binds with phosphorus in foods and prevents absorption.
- C. Promotes stomach emptying and prevents gastric reflux.
- D. Buffers hydrochloric acid and prevents gastric erosion.
Correct Answer: B
Rationale: The correct answer is B. Sevelamer (RenaGel) is a phosphate binder used in ESRD to bind with phosphorus in foods, preventing its absorption in the gastrointestinal tract. This is important as ESRD patients often have high levels of phosphorus in their blood, which can lead to complications like cardiovascular disease. Taking RenaGel with meals ensures that it binds with phosphorus in the food, reducing its absorption.
Choice A is incorrect as RenaGel does not prevent indigestion associated with spicy foods. Choice C is incorrect as RenaGel does not promote stomach emptying or prevent gastric reflux. Choice D is incorrect as RenaGel does not buffer hydrochloric acid or prevent gastric erosion.
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A patient with atrial fibrillation is prescribed warfarin. Which laboratory test should the nurse monitor to assess the effectiveness of the medication?
- A. Complete blood count (CBC)
- B. Prothrombin time (PT)/INR
- C. Partial thromboplastin time (PTT)
- D. Serum potassium level
Correct Answer: B
Rationale: The correct answer is B: Prothrombin time (PT)/INR. This is because warfarin is a medication that affects the clotting ability of the blood by inhibiting vitamin K-dependent clotting factors. PT/INR is the specific laboratory test used to monitor the effectiveness of warfarin therapy. PT measures how long it takes for blood to clot, while INR standardizes the PT results. Monitoring PT/INR helps to ensure that the patient is within the target therapeutic range for anticoagulation.
Incorrect choices:
A: Complete blood count (CBC) - CBC does not directly assess the effectiveness of warfarin therapy.
C: Partial thromboplastin time (PTT) - PTT is used to monitor the effectiveness of heparin therapy, not warfarin.
D: Serum potassium level - Monitoring serum potassium level is not directly related to assessing the effectiveness of warfarin therapy.
A client with a history of peptic ulcer disease is admitted with severe abdominal pain. Which assessment finding should the nurse report to the healthcare provider immediately?
- A. Bowel sounds active in all quadrants.
- B. Blood pressure of 110/70 mm Hg.
- C. Rigid, board-like abdomen.
- D. Heart rate of 90 beats per minute.
Correct Answer: C
Rationale: The correct answer is C: Rigid, board-like abdomen. This finding suggests peritonitis, a serious complication of peptic ulcer disease, requiring immediate medical intervention. A: Active bowel sounds are expected. B: Blood pressure is within normal range. D: Heart rate is slightly elevated but not a critical finding. In summary, a rigid abdomen indicates peritonitis and requires urgent attention compared to the other choices.
A patient with diabetes insipidus is prescribed desmopressin. What is the primary purpose of this medication?
- A. Increase urine output
- B. Reduce blood sugar levels
- C. Decrease urine output
- D. Lower blood pressure
Correct Answer: C
Rationale: Desmopressin is a synthetic form of vasopressin used to replace the hormone in diabetes insipidus. The primary purpose is to decrease urine output by increasing water reabsorption in the kidneys, thereby reducing excessive urination and preventing dehydration. Choice A is incorrect as desmopressin actually decreases urine output. Choice B is incorrect as desmopressin does not directly affect blood sugar levels. Choice D is incorrect as desmopressin does not primarily lower blood pressure.
A patient with rheumatoid arthritis is taking prednisone. What is an important side effect for the nurse to monitor?
- A. Hyperglycemia
- B. Bradycardia
- C. Hypotension
- D. Hyperkalemia
Correct Answer: A
Rationale: The correct answer is A: Hyperglycemia. Prednisone is a corticosteroid that can cause an increase in blood glucose levels by promoting gluconeogenesis and decreasing insulin sensitivity. Monitoring for hyperglycemia is crucial as it can lead to serious complications such as diabetic ketoacidosis. Bradycardia (B) and hypotension (C) are not typical side effects of prednisone, as it tends to cause fluid retention and hypertension. Hyperkalemia (D) is also unlikely as prednisone can actually cause hypokalemia due to increased renal potassium excretion.
While assessing a client with diabetes mellitus, the nurse observes an absence of hair growth on the client's legs. What additional assessment provides further data to support this finding?
- A. Palpate for the presence of femoral pulses bilaterally.
- B. Assess for the presence of a positive Homan's sign.
- C. Observe the appearance of the skin on the client's legs.
- D. Watch the client's posture and balance during ambulation.
Correct Answer: C
Rationale: The correct answer is C: Observe the appearance of the skin on the client's legs. In clients with diabetes mellitus, poor circulation can lead to decreased hair growth on the legs. By observing the skin appearance, the nurse can look for signs of poor circulation such as dry skin, thinning of the skin, or discoloration. This assessment provides further data to support the finding of absent hair growth.
Choices A, B, and D are incorrect because they do not directly relate to the assessment of absent hair growth in clients with diabetes mellitus. Palpating for femoral pulses assesses circulation but does not specifically address the absence of hair growth. Assessing for Homan's sign evaluates for deep vein thrombosis, which is not directly related to hair growth. Watching posture and balance during ambulation assesses mobility and stability but does not provide information on hair growth or circulation in the legs.