Nokea
The nurse is reinforcing teaching about oral hydrocortisone for a client with newly diagnosed primary adrenal insufficiency (i.e., Addison disease). Which of the following information should the nurse reinforce? Select all that apply.
- A. Discontinue hydrocortisone if you have mood changes or disruptions in behavior
- B. Report even a low-grade fever to the health care provider immediately
- C. Report signs of hyperglycemia, including increased urine, hunger, and thirst
- D. The dose of hydrocortisone may need to be increased during times of illness or injury
- E. This medication should be taken on an empty stomach to enhance absorption
Correct Answer: B,C,D
Rationale: Reporting fever, hyperglycemia, and adjusting doses during illness are critical for Addison disease management. Hydrocortisone should not be stopped abruptly, and food enhances absorption.
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The obstetric client is determined to have oligohydramnios. Which fetal anomaly is associated with oligohydramnios?
- A. Diabetes
- B. Renal agenesis
- C. Tracheo-esophageal fistula
- D. Tracheo-esophageal atresia
Correct Answer: B
Rationale: Oligohydramnios, low amniotic fluid, is strongly associated with renal agenesis, as the fetus's kidneys fail to produce urine, a major component of amniotic fluid. Other anomalies listed are less directly related.
The nurse is reviewing new medication prescriptions for a client who has a suspected brain tumor. The client is scheduled for a CT scan of the head with IV iodinated contrast in 24 hours. The nurse should clarify the prescription for
- A. gabapentin
- B. amlodipine
- C. metformin
- D. phenytoin
Correct Answer: C
Rationale: Metformin should be held before and after iodinated contrast due to the risk of lactic acidosis if contrast-induced kidney injury occurs. Gabapentin, amlodipine, and phenytoin are safe with contrast.
The nurse is reinforcing teaching about measures to prevent the transmission of hepatitis A for a group of clients at an outpatient treatment facility for substance use disorders. Which of the following information would be most important for the nurse to include?
- A. Avoid drinking tap water at home
- B. Do not share needles if you inject recreational substances
- C. Practice safe sex by using condoms
- D. Wash your hands thoroughly after toileting and before eating
Correct Answer: D
Rationale: Hepatitis A is transmitted via the fecal-oral route, making handwashing after toileting and before eating critical. Tap water, needle sharing, and sex are not primary transmission modes for hepatitis A.
The orthopedic health care provider instructs a client with a fractured right femur, who has been non-weight bearing for the past 5 weeks, to progress to full-weight bearing on the right leg. Which advanced crutch gait that most closely resembles normal walking should the nurse reinforce when teaching the client?
- A. 2-point gait
- B. 3-point gait
- C. 4-point gait
- D. 5-point gait
Correct Answer: A
Rationale: The 2-point gait mimics normal walking, alternating crutch and opposite leg, suitable for full-weight bearing. 3-point is for non-weight bearing, 4-point is slower, and 5-point does not exist.
Which of the following is a common complaint of the client with end-stage renal failure?
- A. Weight loss
- B. Itching
- C. Ringing in the ears
- D. Bruising
Correct Answer: B
Rationale: Itching is common in end-stage renal failure due to uremia and phosphate accumulation. Weight loss , tinnitus , and bruising are less specific.