Nokea
The nurse is caring for a client with a history of atrial fibrillation who is prescribed dofetilide (Tikosyn). The nurse should monitor the client for which of the following side effects?
- A. Hypertension.
- B. Bradycardia.
- C. Torsades de pointes.
- D. Weight gain.
Correct Answer: C
Rationale: Dofetilide can cause torsades de pointes, a life-threatening arrhythmia, requiring close monitoring.
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Which of the following abnormal serum chemistry results is a client with cirrhosis who has developed ascites likely to have?
- A. Decreased aspartate aminotransferase.
- B. Hypoalbuminemia.
- C. Hyperkalemia.
- D. Decreased alanine aminotransferase.
Correct Answer: B
Rationale: Cirrhosis impairs liver protein synthesis, leading to hypoalbuminemia, which causes ascites due to decreased oncotic pressure.
Which of these case management methods employs the intrinsic use of multidisciplinary plans of care that are based on the client's current condition, and reflect interventions and expected outcomes within a pre-established time line?
- A. The Case Manager Model
- B. The ProACT Model
- C. The Collaborative Practice Model
- D. The Triad Model of Case Management
Correct Answer: D
Rationale: The Triad Model of Case Management uses multidisciplinary plans of care based on the client's current condition, with interventions and expected outcomes within a pre-established timeline, involving collaboration among nursing, social work, and utilization review teams.
A 5-year-old child is admitted with a fever and rash. The nurse suspects scarlet fever. Which assessment finding supports this diagnosis?
- A. Strawberry tongue
- B. Koplik spots
- C. Vesicular rash
- D. Pustules on the trunk
Correct Answer: A
Rationale: Strawberry tongue is a characteristic sign of scarlet fever, caused by group A Streptococcus, aiding in diagnosis confirmation.
A client is receiving spironolactone (Aldactone) for treatment of bilateral lower extremity edema. The nurse should instruct the client to make which of the following nutritional modifications to prevent an electrolyte imbalance?
- A. Increase intake of milk and milk products.
- B. Restrict fluid intake to 1000 mL per day.
- C. Decrease foods high in potassium.
- D. Decrease foods high in sodium.
Correct Answer: C
Rationale: Spironolactone is a potassium-sparing diuretic, so decreasing potassium-rich foods prevents hyperkalemia. Sodium restriction may help edema but is less critical for electrolyte balance in this context.
A female client with paranoid schizophrenia has been hearing negative voices and 'getting special messages from various sources,' which of the following interventions is most appropriate for the client's symptoms?
- A. Asking her to make simple decisions
- B. Being matter-of-fact with her
- C. Monitoring her reactions to television programs
- D. Reinforcing appropriate dress and hygiene
Correct Answer: B
Rationale: Being matter-of-fact helps ground a client with paranoid schizophrenia, reducing misinterpretations of reality. Decision-making, TV monitoring, or hygiene reinforcement are less directly related to auditory hallucinations.