Nokea
The nurse is teaching a client with a new diagnosis of heart failure about furosemide (Lasix). Which of the following statements by the client indicates a need for further teaching?
- A. I should report muscle cramps to my doctor.
- B. I should take this medication in the morning.
- C. I should eat foods high in potassium.
- D. I should stop this medication if I feel better.
Correct Answer: D
Rationale: Stopping furosemide when feeling better is incorrect, as heart failure requires lifelong treatment to manage fluid overload. Options A, B, and C are correct: muscle cramps may indicate hypokalemia, morning dosing minimizes nocturia, and potassium-rich foods are recommended.
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A 69-year-old man is receiving dexamethasone (Decadron) 3 mg PO TID for chronic lymphocytic leukemia. It is MOST important for the nurse to report which of the following findings to the physician?
- A. PT 12 seconds and Hgb 15 g/dL.
- B. BUN 18 mg/dL and creatinine 1.0 mg/dL.
- C. K⺠3.4 mEq/L and CA⺠5/5 mEq/L.
- D. AST (SGOT) 18 U/L and ALT (SGPT) 12 U/L.
Correct Answer: C
Rationale: normal Kâ 3.5-5.0 mEq/L, normal Ca 4.5-5.3 mEq/L, indicates hypokalemia and hypercalcemia
A mother brings her 26 month-old to the well-child clinic. She expresses frustration and anger due to her child's constantly saying 'no' and his refusal to follow her directions. The nurse explains this is normal for his age, as negativism is attempting to meet which developmental need?
- A. Trust
- B. Initiative
- C. Independence
- D. Self-esteem
Correct Answer: C
Rationale: Independence. In Erikson's theory of development, toddlers struggle to assert independence, often using the word 'no' to establish autonomy.
A client diagnosed with chronic depression is maintained on tranylcypromine (Parnate). An important nursing intervention is to teach the client to avoid which of the following foods?
- A. Wine, beer, cheese, liver and chocolate
- B. Wine, citrus fruits, yogurt and broccoli
- C. Beer, cheese, beef and carrots
- D. Wine, apples, sour cream and beef steak
Correct Answer: A
Rationale: These foods are tyramine-rich and ingestion of these foods while taking monoamine oxidase inhibitors (MAOIs) can precipitate a life-threatening hypertensive crisis.
Which of the following is the BEST method for the nurse to use when evaluating the effectiveness of tracheal suctioning?
- A. Note subjective data, such as 'My breathing is much improved now.'
- B. Note objective findings, such as decreased respiratory rate and pulse.
- C. Consult with the respiratory therapist to determine effectiveness.
- D. Auscultate the chest for change or clearing of adventitious breath sounds.
Correct Answer: D
Rationale: to assess the effectiveness of suctioning, auscultate the client's chest to determine if the adventitious sounds are cleared and to ensure that the airway is clear of secretions.
The nurse is teaching a client with a new diagnosis of hyperthyroidism about methimazole (Tapazole). Which of the following instructions should the nurse include?
- A. Take the medication with grapefruit juice.
- B. Report any fever or sore throat.
- C. Stop the medication if thyroid levels normalize.
- D. Avoid regular thyroid function Test s.
Correct Answer: B
Rationale: Fever or sore throat may indicate agranulocytosis, a serious methimazole side effect. Options A, C, and D are incorrect.