Nokea
The nurse is screening clients for those at risk of developing nephrolithiasis. Which of the following factors would increase a client's risk of developing nephrolithiasis?
- A. gout
- B. dehydration
- C. hypokalemia
- D. thrombocytopenia
- E. hyperparathyroidism
Correct Answer: A,B,E
Rationale: Gout (A), dehydration (B), and hyperparathyroidism (E) increase nephrolithiasis risk due to uric acid, concentrated urine, and calcium imbalances, respectively. Hypokalemia (C) and thrombocytopenia (D) are unrelated.
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An 81-year-old client is admitted to a rehabilitation facility 3 days after total hip replacement. The next morning, the unlicensed assistive personnel (UAP) takes the client's vital signs, but when the UAP returns to assist the client with a shower, the client curses at and tries to hit the UAP. Which is the most appropriate response by the practical nurse?
- A. I will walk to the room to observe the client's behavior.
- B. It sounds like the client is not satisfied with the care provided. I'll see if we can make the client more comfortable.
- C. Just leave the client alone now and try again later.
- D. The client probably has dementia and is under a lot of stress with the change of environment.
Correct Answer: A
Rationale: Observing the client (A) allows assessment of the behavior's cause. Assuming dissatisfaction (B) or dementia (D) is premature. Leaving the client (C) delays intervention.
The nurse is caring for a client who has chickenpox with open lesions. Which of the following infection control precautions should the nurse implement?
- A. Place the client in a private room with monitored negative air pressure.
- B. Ensure that pregnant staff members are not assigned to care for the client.
- C. Put a surgical mask on the client during transport outside of the assigned room.
- D. Wear a protective gown, clean gloves, and an N95 respirator mask when caring for the client.
- E. Prevent visitors from entering the client's room for 24 hours from the initial appearance of symptoms.
Correct Answer: A,B,C,D
Rationale: Chickenpox requires airborne and contact precautions: negative pressure room (A), protecting pregnant staff (B), masking during transport (C), and gown, gloves, N95 (D). Visitor restriction (E) is too short; it lasts until lesions crust.
The charge nurse in a long-term care facility is making assignments. When assigning personnel to care for residents, which principle is important?
- A. Assignments should be rotated on a daily basis.
- B. Clients who are confused often do better with the same caregiver for several days.
- C. Female caregivers should not care for male residents.
- D. Caregivers should be allowed to select the residents they will care for.
Correct Answer: B
Rationale: Consistency with caregivers reduces anxiety and improves trust for confused clients, enhancing care quality. Daily rotation, gender restrictions, or caregiver choice are less effective.
The nurse is caring for a child newly diagnosed with cystic fibrosis. What interventions does the nurse expect to be included in the client's multidisciplinary plan of care?
- A. Chest physiotherapy
- B. Genetic counseling
- C. Low-calorie diet
- D. Oral fluid restriction
- E. Spiritual support
Correct Answer: A,B,E
Rationale: Chest physiotherapy (A) clears mucus, genetic counseling (B) addresses hereditary aspects, and spiritual support (E) aids coping. A high-calorie diet, not low-calorie (C), is needed for nutrition. Fluid restriction (D) is inappropriate, as hydration is encouraged.
The nurse is teaching a client with dysrhythmia about the electrical pathway of an impulse as it travels through the heart. Which of these describes the normal pathway?
- A. AV node, SA node, Bundle of His, Purkinje fibers
- B. Purkinje fibers, SA node, AV node, Bundle of His
- C. Bundle of His, Purkinje fibers, SA node
- D. SA node, AV node, Bundle of His, Purkinje fibers
Correct Answer: D
Rationale: SA node, AV node, Bundle of His, Purkinje fibers. This is the normal pathway of an electrical impulse through the heart.