Nokea
The nurse is reviewing laboratory reports for a client who is taking allopurinol (Zyloprim). Which of the following indicate that the drug has had a therapeutic effect?
- A. Decreased urine alkaline phosphatase level.
- B. Increased urine calcium excretion.
- C. Increased serum calcium level.
- D. Decreased serum uric acid level.
Correct Answer: D
Rationale: Allopurinol reduces serum uric acid levels, indicating therapeutic effectiveness in preventing uric acid stone formation.
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One month following a subtotal gastrectomy for cancer, the nurse is evaluating the nursing care goal related to nutrition. Which of the following indicates that the client has attained the goal? The client has:
- A. Regained weight loss.
- B. Resumed normal dietary intake of three meals a day.
- C. Controlled nausea and vomiting through regular use of antiemetics.
- D. Achieved optimal nutritional status through oral or parenteral feedings.
Correct Answer: D
Rationale: Achieving optimal nutritional status, whether through oral or parenteral feedings, is the primary goal one month post-gastrectomy, as it indicates the client is meeting nutritional needs.
A client with peripheral vascular disease has bypass surgery. The primary goal of the plan of care after surgery is to:
- A. Maintain circulation
- B. Prevent infection
- C. Relieve pain
- D. Provide education
Correct Answer: A
Rationale: The primary goal post-bypass surgery for PVD is to maintain circulation, ensuring graft patency and adequate blood flow to the extremity to prevent ischemia or graft failure. Infection prevention, pain relief, and education are important but secondary to circulation.
A client is beginning external beam radiation therapy to the right axilla after a lumpectomy for breast cancer. Which of the following should the nurse include in client teaching?
- A. Use a heating pad under the right arm.
- B. Place ice on the area after each treatment.
- C. Apply deodorant only under the left arm.
- D. Use a soft washcloth to gently cleanse the area.
Correct Answer: C
Rationale: Applying deodorant only under the left arm avoids irritation to the radiated right axilla, which is sensitive and prone to skin reactions during treatment.
The nurse is caring for a client with angle-closure glaucoma. Which prescription should the nurse anticipate from the primary healthcare provider (PHCP)?
- A. timolol
- B. hydroxyzine
- C. phenylephrine
- D. imipramine
Correct Answer: A
Rationale: Timolol, a beta-blocker, reduces intraocular pressure in angle-closure glaucoma by decreasing aqueous humor production. Hydroxyzine, phenylephrine, and imipramine are not used for this condition.
The physician prescribes metoclopramide hydrochloride (Reglan) for the client with hiatal hernia. The nurse plans to instruct the client that this drug is used in hiatal hernia therapy to accomplish which of the following objectives?
- A. Increase tone of the esophageal sphincter.
- B. Neutralize gastric secretions.
- C. Ease gastric emptying.
- D. Reduce secretion of digestive juices.
Correct Answer: C
Rationale: Metoclopramide promotes gastric emptying, reducing the volume of gastric contents that can reflux in hiatal hernia.