Nokea
The nurse is caring for a pregnant client diagnosed with acute pyelonephritis. Which scientific rationale supports the client being hospitalized for this condition?
- A. The client must be treated aggressively to prevent maternal/fetal complications.
- B. The nurse can force the client to drink fluids and avoid nausea and vomiting.
- C. The client will be dehydrated and there won’t be sufficient blood flow to the baby.
- D. Pregnant clients historically are afraid to take the antibiotics as ordered.
Correct Answer: A
Rationale: Acute pyelonephritis in pregnancy risks maternal sepsis and fetal complications (e.g., preterm labor). Hospitalization ensures aggressive IV antibiotic treatment and monitoring. Dehydration and antibiotic fears are secondary concerns.
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The nurse is caring for a client diagnosed with diabetic ketoacidosis (DKA). Which statement best explains the scientific rationale for the client’s Kussmaul’s respirations?
- A. The kidneys produce excess urine and the lungs try to compensate.
- B. The respirations increase the amount of carbon dioxide in the bloodstream.
- C. The lungs speed up to release carbon dioxide and increase the pH.
- D. The shallow and slow respirations will increase the HCO3 in the serum.
Correct Answer: C
Rationale: Kussmaul’s respirations (rapid, deep breathing) in DKA compensate for metabolic acidosis by excreting carbon dioxide, a volatile acid, to raise blood pH. Kidneys excrete acid, not urine, and respirations do not increase CO2 or HCO3.
The client diagnosed with ARF is experiencing hyperkalemia. Which medication should the nurse prepare to administer to help decrease the potassium level?
- A. Erythropoietin.
- B. Calcium gluconate.
- C. Regular insulin.
- D. Osmotic diuretic.
Correct Answer: C
Rationale: Regular insulin, often given with glucose, drives potassium into cells, temporarily lowering serum potassium levels in hyperkalemia. Calcium gluconate stabilizes cardiac membranes, erythropoietin treats anemia, and osmotic diuretics are not used for hyperkalemia.
What is the primary reason for administering a laxative before the procedure?
- A. To the bowel aids in examining the lower GI tract.
- B. Emptying the bowel prevents accidental stool incontinence during the X-ray.
- C. Emptying the bowel reduces the potential for constipation or impaction.
- D. Emptying the bowel improves the ability to visualize the urinary structures.
Correct Answer: D
Rationale: Emptying the bowel before intravenous pyelography (IVP) enhances visualization of the urinary structures by reducing interference from fecal matter.
The nurse is discussing how to prioritize care with the UAP. Which client should the nurse instruct the UAP to see first?
- A. The immobile client who needs sequential compression devices removed.
- B. The elderly woman who needs assistance ambulating to the bathroom.
- C. The surgical client who needs help changing the gown after bathing.
- D. The male client who needs the intravenous catheter discontinued.
Correct Answer: B
Rationale: Assisting an elderly woman to the bathroom prevents falls and addresses immediate elimination needs, prioritizing safety. Removing SCDs, changing gowns, and discontinuing IVs are less urgent.
Which intervention should the nurse include when preparing a teaching plan for the client with chronic prostatitis?
- A. Sit in a warm sitz bath for 10 to 20 minutes several times daily.
- B. Sit in the chair with the feet elevated for two (2) hours daily.
- C. Drink at least 3,000 mL of oral fluids, especially tea and coffee, daily.
- D. Stop broad-spectrum antibiotics as soon as the symptoms subside.
Correct Answer: A
Rationale: Warm sitz baths reduce inflammation and pain in chronic prostatitis. Elevating feet is unrelated, tea/coffee are bladder irritants, and stopping antibiotics early risks recurrence.