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.
A nurse is collecting data on a 58-year-old client with blurred vision and reduced visual fields. The nurse finds which manifestation most concerning?
- A. Difficulty adjusting to dimmed lights
- B. Extreme eye pain
- C. Gradual loss of peripheral vision
- D. Opaque appearance of lens
Correct Answer: B
Rationale: Extreme eye pain (B) suggests acute conditions like glaucoma, requiring urgent attention. Difficulty in dim light (A), peripheral vision loss (C), and cataracts (D) are less acute.
The nurse is providing home care to an elderly woman who had a cerebrovascular accident several weeks ago. All of the following need to be done. Which should the nurse plan to do first?
- A. Auscultate lung fields
- B. Hygienic care
- C. Assist with ambulation
- D. Range-of-motion (ROM) exercises
Correct Answer: A
Rationale: Auscultating lung fields assesses respiratory status, a priority post-CVA to detect complications like pneumonia or atelectasis. Hygienic care, ambulation, and ROM are secondary.
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.
A woman is pregnant for the first time and is Rh negative. Her husband is Rh positive. She tells the nurse that he is very worried about her baby. Which information should the nurse plan to include when talking with this woman?
- A. The first baby should not be affected.
- B. She will need to get treatment after the second baby is born.
- C. There is nothing that can be done to prevent the baby from developing erythroblastosis fetalis, but it can be treated.
- D. She can have intrauterine transfusion for the first baby if blood levels indicate that the child is affected.
Correct Answer: A
Rationale: The first Rh-positive baby is typically unaffected as maternal antibodies develop post-delivery. RhoGAM is given after birth to prevent issues in future pregnancies, not after the second baby.