Nokea
The nurse is teaching a client with a new diagnosis of chronic kidney disease about sevelamer (Renagel). Which of the following statements by the client indicates a need for further teaching?
- A. I should take this medication with meals.
- B. I should report constipation to my doctor.
- C. I should avoid taking this with my calcium supplement.
- D. I should stop this medication if my phosphate levels are normal.
Correct Answer: D
Rationale: Stopping sevelamer when phosphate levels are normal is incorrect, as chronic kidney disease requires ongoing phosphate control to prevent complications. Options A, B, and C are correct: taking with meals binds phosphate, constipation is a side effect, and calcium supplements interfere with absorption.
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A client has returned from surgery with a fine, reddened rash noted around the area where Betadine prep had been applied prior to surgery. Nursing documentation in the chart should include
- A. the time and circumstances under which the rash was noted.
- B. the explanation given to the client and family of the reason for the rash.
- C. notation on an allergy list and notification of the doctor.
- D. the need for application of corticosteroid cream to decrease inflammation.
Correct Answer: C
Rationale: suspected reaction to drugs should be reported to the doctor and noted on list of possible allergies
A 28-year-old client is admitted to the hospital unit with hepatitis A. The nurse knows that the client's overall care during hospitalization should include which of the following?
- A. Protective isolation.
- B. Airborne precautions.
- C. Standard precautions.
- D. Droplet precautions.
Correct Answer: C
Rationale: standard precautions should be used on everyone; sources for this virus are saliva, feces, and blood; use contact isolation if fecal incontinence
A toddler with Tetralogy of Fallot is hospitalized with a diagnosis of pneumonia. During the nursing assessment, the child develops a hypoxic episode. The nurse should:
- A. Provide the child his favorite toy.
- B. Place the child in a supine position.
- C. Pick the child up and comfort him.
- D. Place the child in knee chest position.
Correct Answer: D
Rationale: The knee-chest position increases systemic vascular resistance, reducing right-to-left shunting in Tetralogy of Fallot during hypoxia. Toys or comforting do not address hypoxia. Supine position may worsen shunting.
Treatment of sickle cell crises includes the application of:
- A. A heating pad to the joints
- B. An ice pack to the joints
- C. A CPM device to the lower leg
- D. A TENS unit to the back
Correct Answer: A
Rationale: Heat application to joints during sickle cell crises promotes vasodilation, improving blood flow and reducing pain from vaso-occlusion. Ice may worsen vasoconstriction, CPM is irrelevant, and TENS is not standard for sickle cell pain.
A client with acromegaly will most likely experience which symptom?
- A. Bone pain
- B. Frequent infections
- C. Fatigue
- D. Weight loss
Correct Answer: A
Rationale: Acromegaly, caused by excess growth hormone, often leads to bone pain due to bone overgrowth. Infections , fatigue , and weight loss are less specific symptoms.