Nokea
The nurse is reviewing blood pressure readings for a group of clients on a medical unit. Which client is at the highest risk for complications related to hypertension?
- A. Post-menopausal Caucasian female who overeats and is 20% above her ideal body weight.
- B. Young adult Hispanic female who has hemoglobin at 11 g/dl (110 g/L) and drinks beer daily.
- C. Older adult who consumes a diet of smoked, cured, and pickled foods.
- D. Middle-aged African-American male who has a serum creatinine level of 2.9 mg/dL (256.4 micromol/L).
Correct Answer: D
Rationale: The correct answer is D. An elevated serum creatinine level indicates kidney damage, which significantly increases the risk of complications from hypertension. High blood pressure can damage the kidneys over time, leading to impaired kidney function. Choices A, B, and C do not directly correlate with increased risk of complications related to hypertension. Choice A focuses on obesity and overeating, Choice B on anemia and alcohol consumption, and Choice C on a diet high in sodium and nitrates, none of which are as directly related to hypertension complications as kidney damage.
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The nurse is triaging clients who have been injured during a tornado. Which client requires immediate action?
- A. A young male with a minor laceration on his forearm.
- B. An elderly woman with a dislocated shoulder who is calm.
- C. A middle-aged female with a broken humerus who is unable to follow commands and is crying.
- D. A teenager with abrasions and a bruised knee.
Correct Answer: C
Rationale: The middle-aged female with a broken humerus who is unable to follow commands and is crying requires immediate action. These symptoms indicate a possible head injury or severe emotional distress that need urgent attention. Choice A is not as urgent since a minor laceration can be addressed after more critical cases. Choice B, although having a dislocated shoulder, is stable, as the client is calm. Choice D presents with minor injuries that can wait while more critical cases are addressed.
An adolescent female asks the nurse about taking retinoic acid (Accutane). What guidance should be provided by the nurse?
- A. The medication should be used for 10 weeks only.
- B. The medication requires that sexually active females use contraception.
- C. The medication lowers hemoglobin levels very quickly.
- D. The medication has few side effects.
Correct Answer: B
Rationale: The correct guidance the nurse should provide is that sexually active females must use contraception while taking Accutane and for 1 month after the 20 weeks it is prescribed. Choice A is incorrect because Accutane is typically taken for a longer duration than 10 weeks. Choice C is incorrect because Accutane does not lower hemoglobin levels quickly. Choice D is incorrect as Accutane is known for having many side effects, including the risk of birth defects.
A male client with acquired immune deficiency syndrome (AIDS) and Pneumocystis carinii pneumonia has a CD4+ T cell count of 200 cells/microliter. The client asks the nurse why he keeps getting these massive infections. Which pathophysiologic mechanism should the nurse describe in response to the client's question?
- A. Bone marrow suppression of white blood cells causes insufficient cells to phagocytize organisms.
- B. Exposure to multiple environmental infectious agents overburdens the immune system until it fails.
- C. The humoral immune response lacks B cells that form antibodies and opportunistic infections result.
- D. Inadequate numbers of T lymphocytes are available to initiate cellular immunity and macrophages.
Correct Answer: D
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
A young client who is being taught how to use an inhaler for symptoms of asthma tells the nurse about the intention to use the inhaler but plans to continue smoking cigarettes. In evaluating the client's response, what is the best initial action by the nurse?
- A. Explain the risks of smoking with asthma.
- B. Revise the plan of care.
- C. Encourage the client to reduce smoking gradually.
- D. Provide resources for smoking cessation.
Correct Answer: B
Rationale: The best initial action by the nurse is to revise the plan of care. This is necessary to address the client's intention to continue smoking and ensure that appropriate support and education are provided. Choice A is not the best initial action as the client is already aware of the risks of smoking with asthma. Choice C might not be effective as the client's intention to continue smoking poses a significant risk to their health. Choice D, providing resources for smoking cessation, is important but revising the plan of care should come first to address the immediate concern.
The mother of a child with acute laryngotracheobronchitis (LTB) asks why her child must be kept NPO. Which response would be the most correct?
- A. The epinephrine given causes nausea and vomiting.
- B. The child is being hydrated with IV fluids.
- C. The child is not hungry.
- D. The child's rapid respirations pose a risk for aspiration.
Correct Answer: D
Rationale: The correct answer is D because rapid respirations predispose to aspiration in a child with acute laryngotracheobronchitis. Choice A is incorrect because epinephrine does not directly relate to the need for NPO status. Choice B is incorrect as hydration with IV fluids is not the primary reason for keeping the child NPO. Choice C is incorrect as the child being hungry is not the main concern when keeping a child NPO in this situation.