Nokea
The nurse is teaching a client with a history of atrial fibrillation about medication adherence. The nurse should tell the client to:
- A. Take anticoagulants as prescribed
- B. Skip doses if feeling better
- C. Increase caffeine intake
- D. Avoid hydration
Correct Answer: A
Rationale: Anticoagulants reduce stroke risk in atrial fibrillation, so adherence is critical.
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A client is being discharged with albuterol (Proventil) and beclomethasone dipropionate (Vanceril) to be administered via inhalation three times a day and at bedtime. Client teaching regarding the sequential order in which the drugs should be administered includes:
- A. Glucocorticoid followed by the bronchodilator
- B. Bronchodilator followed by the glucocorticoid
- C. Alternate successive administrations
- D. According to the client's preference
Correct Answer: B
Rationale: The client would not receive therapeutic effects of the glucocorticoid when it is inhaled through constricted airways. Bronchodilating the airways first allows for the glucocorticoid to be inhaled through open airways and increases the penetration of the steroid for maximum effectiveness of the drug. Inaccurate use of the inhalers will lead to decreased effectiveness of the treatment. Client teaching regarding the use and effects of inhalers will promote client understanding and compliance.
Which of the following menu choices would indicate that a client with pressure ulcers understands the role diet plays in restoring her albumin levels?
- A. Broiled fish with rice
- B. Bran flakes with fresh peaches
- C. Lasagna with garlic bread
- D. Cauliflower and lettuce salad
Correct Answer: A
Rationale: Broiled fish and rice are excellent protein sources, aiding in restoring albumin levels for tissue repair. The other options are lower in protein.
A client with a history of a hiatal hernia is being discharged. The nurse should teach the client to:
- A. Sleep in a reclining position
- B. Eat large meals
- C. Avoid carbonated beverages
- D. Lie down after eating
Correct Answer: C
Rationale: Carbonated beverages increase gastric pressure, worsening hiatal hernia symptoms. Sleeping upright, small meals, and avoiding lying down post-meals are also recommended.
What specific hormone must be present in serum or urine laboratory tests used to diagnose pregnancy?
- A. Human chorionic gonadotropin
- B. Estrogen
- C. α-fetoprotein
- D. Sphingomyelin
Correct Answer: A
Rationale: Human chorionic gonadotropin is the biochemical basis for pregnancy tests, produced by the placenta to maintain the corpus luteum.
The nurse is preparing to receive a client from admitting with tumor lysis syndrome (TLS). Which of the following would the nurse expect to find on the laboratory and patient history sections of the chart?
- A. Low blood pressure
- B. Hyperactivity
- C. Hyperkalemia
- D. Hyperuricemia
- E. Mental changes
Correct Answer: A,C,D,E
Rationale: TLS causes hyperkalemia (C), hyperuricemia (D), and mental changes (E) due to electrolyte imbalances and low blood pressure (A) from fluid shifts. Hyperactivity (B) is not typical.