Nokea
The nurse is analyzing laboratory values for the assigned clients. Which finding, based on the client's medical history, indicates the need for immediate follow-up?
- A. Client with chronic kidney disease and serum creatinine of 1.6 mg/dL
- B. Client with diabetes mellitus and a glycosylated hemoglobin A1c (HbA1c) of 7.0%
- C. Client with heart failure and a B-type natriuretic peptide (BNP) of 140 pg/mL
- D. Client who is male and has anemia with hemoglobin of 16.5 g/dL and hematocrit of 45%
Correct Answer: B
Rationale: An HbA1c of 7.0% in a client with diabetes mellitus indicates poor long-term glucose control, necessitating immediate follow-up. Choice A, chronic kidney disease with a serum creatinine of 1.6 mg/dL, though concerning, does not indicate an immediate need for follow-up. Choice C, heart failure with a BNP of 140 pg/mL, may require monitoring but not immediate follow-up. Choice D, a male client with anemia and normal hemoglobin and hematocrit levels, does not warrant immediate attention based on the provided information.
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Which of the following drugs may cause weight gain?
- A. Amphetamines
- B. Steroids
- C. Antibiotics
- D. Nonsteroidal anti-inflammatory drugs
Correct Answer: B
Rationale: The correct answer is B, Steroids. Steroids are known to cause weight gain as a side effect. Amphetamines, choice A, are more likely to cause appetite suppression and weight loss. Antibiotics, choice C, and nonsteroidal anti-inflammatory drugs, choice D, are not typically associated with weight gain as a common side effect.
The client has been diagnosed with hemorrhoids. Which statement from the client indicates that further teaching is needed?
- A. "I should increase fruits, bran, and fluids in my diet."
- B. "I will use warm compresses and take sitz baths daily."
- C. "I must take a laxative every night and have a stool daily."
- D. "I can use an analgesic ointment or suppository for pain."
Correct Answer: C
Rationale: Choice C indicates the need for further teaching because regular use of laxatives can lead to dependence and is not recommended for hemorrhoids. Increased fiber intake and fluid consumption (Choice A) help prevent constipation, warm compresses and sitz baths (Choice B) provide relief, and using analgesic ointments or suppositories (Choice D) can help manage pain associated with hemorrhoids.
The client is complaining of painful swallowing secondary to mouth ulcers. Which statement by the client indicates appropriate management?
- A. "I will brush my teeth with a soft-bristle toothbrush."
- B. "I will rinse my mouth with Listerine mouthwash."
- C. "I will swish my antifungal solution and then swallow."
- D. "I will avoid spicy foods, tobacco, and alcohol."
Correct Answer: D
Rationale: The correct answer is D. Avoiding irritants like spicy foods, tobacco, and alcohol is crucial in managing mouth ulcers as they can further irritate and worsen the condition. Choice A is incorrect as using a soft-bristle toothbrush may still cause discomfort. Choice B is incorrect as alcohol-containing mouthwashes can be irritating. Choice C is incorrect as swallowing antifungal solution meant for topical use is not appropriate and can be harmful.
Are M6 practical nurses utilized in field units with patient holding capabilities?
- A. Yes
- B. No
- C. -
- D. -
Correct Answer: A
Rationale: Yes, M6 practical nurses are utilized in field units with patient holding capabilities. They play a crucial role in providing care and support in these settings. Choice B is incorrect as M6 practical nurses are indeed utilized in such field units, as stated in the extract. Choices C and D are not applicable as the correct answer is 'Yes.'
Which potential complication should the nurse assess for in the client with infective endocarditis who has embolization of vegetative lesions from the mitral valve?
- A. Pulmonary embolism
- B. Decreased urine output
- C. Hemoptysis
- D. Deep vein thrombosis
Correct Answer: B
Rationale: The correct answer is 'Decreased urine output.' Embolization of vegetative lesions from the mitral valve can cause renal infarction, leading to a decrease in urine output. This complication is due to the obstruction of blood flow to the kidneys. Choices A, C, and D are incorrect because embolization from the mitral valve typically does not directly cause pulmonary embolism, hemoptysis, or deep vein thrombosis.