Nokea
The nurse is talking to a group of clients who are postmenopause. Which of the following statements would be appropriate for the nurse to make? Select all that apply.
- A. Speak with your health care provider about monitoring your cholesterol levels.
- B. Increase your intake of green, leafy vegetables and low-fat dairy products
- C. Expect episodes of harmless intermittent vaginal bleeding.
- D. Seek support to cope with any emotional symptoms
- E. Engage in a weight-bearing exercise regimen.
Correct Answer: A,B,D,E
Rationale: Monitoring cholesterol, increasing nutrient-rich foods, seeking emotional support, and weight-bearing exercise are appropriate for postmenopausal health. Vaginal bleeding is not normal and requires evaluation.
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An African American client comes to the clinic for a follow-up visit 2 months after starting enalapril for hypertension. Which client statement should be reported to the health care provider immediately?
- A. Is there anything I can take for my dry, hacking cough?
- B. My blood pressure this morning was 158/84 mm Hg.
- C. Sometimes I feel a little dizzy when I stand up.
- D. Will you look at my tongue? It feels thicker than normal.
Correct Answer: D
Rationale: A thicker tongue may indicate angioedema, a rare but life-threatening side effect of enalapril (an ACE inhibitor), requiring immediate reporting. A (dry cough) and C (dizziness) are common side effects that warrant monitoring but are less urgent. B indicates suboptimal blood pressure control, which requires follow-up but is not immediately life-threatening.
A thyroid scan, a cardiac catheterization, a gallbladder x-ray, and an intravenous pyelogram are ordered for a client. Which test should the nurse schedule to be done first?
- A. Thyroid scan
- B. Cardiac catheterization
- C. Gallbladder x-ray
- D. Intravenous pyelogram
Correct Answer: A
Rationale: Thyroid scans use radioactive iodine, which can interfere with other tests' contrast agents or imaging. Scheduling it first prevents interaction with cardiac catheterization, gallbladder x-ray, or IVP.
The nurse is auscultating an elderly bedridden client's breath sounds and hears crackles. What is the best interpretation of this finding?
- A. This is normal for the client's age.
- B. This is suggestive of an immediately life-threatening condition.
- C. This is an indication that the client needs to take deep breaths.
- D. This is an indication that the client may need nasal oxygen.
Correct Answer: C
Rationale: Crackles in a bedridden elderly client suggest fluid in the lungs or atelectasis, which deep breathing can help clear. It's not normal, not immediately life-threatening, and oxygen is premature without further assessment.
A client with seizure disorder has an order for Dilantin (Phenytoin). Which of the following is not a side effect of Dilantin (Phenytoin)?
- A. Gingival hypertrophy
- B. Insomnia
- C. Diarrhea
- D. Slurred speech
Correct Answer: B
Rationale: Dilantin causes gingival hypertrophy, slurred speech, and occasionally diarrhea, but insomnia is not a common side effect.
A client with type 1 diabetes has a prescription for 20 units of NPH insulin daily at 7:30 AM and regular insulin before meals, based on a sliding scale. At 7:00 AM, the client's blood glucose level is 220 mg/dL (12.2 mmol/L), and the client's breakfast tray has arrived. What action should the nurse take?
- A. Administer 20 units of NPH insulin now and then 6 units of regular insulin after the morning meal
- B. Administer 26 units of insulin: 20 units of NPH insulin and 6 units of regular insulin in 2 separate injections
- C. Administer 26 units of insulin: 20 units of NPH mixed with 6 units of regular insulin in the same syringe, drawing up the NPH into the syringe first
- D. Administer 26 units of insulin: 20 units of NPH mixed with 6 units of regular insulin in the same syringe, drawing up the regular insulin first
Correct Answer: D
Rationale: Regular insulin is drawn up first to prevent NPH contamination, and both can be mixed in one syringe for a blood glucose of 220 mg/dL, assuming a sliding scale of 6 units. Administering after the meal or using separate injections is incorrect.