Nokea
The patient is being discharged on furosemide (Lasix). The nurse evaluates the patient as understanding her medication teaching if she states that she will have which of the ff. laboratory tests monitored as ordered?
- A. “I will have my urine sodium checked.”
- B. “I will have my prothrombin time checked.”
- C. “I will have my calcium level checked.”
- D. “I will have my potassium level checked.”
Correct Answer: D
Rationale: The correct answer is D: "I will have my potassium level checked." Furosemide is a loop diuretic that can cause potassium loss, leading to hypokalemia. Monitoring potassium levels is crucial to prevent complications such as cardiac arrhythmias.
A: Monitoring urine sodium is not typically necessary for furosemide therapy.
B: Prothrombin time monitoring is unrelated to furosemide therapy.
C: Monitoring calcium levels is not directly affected by furosemide use.
In summary, monitoring potassium levels is essential due to the potential for hypokalemia with furosemide, while the other options are not directly relevant to this medication.
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What should a male client over age 50 do to help ensure early identification of prostate cancer?
- A. Have a digital rectal examination and prostate-specific antigen (PSA) test done yearly
- B. Have a transrectal ultrasound every 5 years
- C. Perform monthly testicular self-examinations, especially after age 50
- D. Have a complete blood count (CBC) and blood urea nitrogen (BUN) and creatinine levels
Correct Answer: A
Rationale: Rationale:
1. Digital rectal exam (DRE) and PSA test are recommended by major health organizations for prostate cancer screening in men over 50.
2. DRE helps detect abnormalities in the prostate, while PSA test measures the levels of a protein produced by the prostate gland.
3. Prostate cancer can be asymptomatic in its early stages, so regular screening is crucial for early detection and treatment.
4. Transrectal ultrasound is not a primary screening method for prostate cancer.
5. Testicular self-exams are for detecting testicular cancer, not prostate cancer.
6. CBC, BUN, and creatinine levels are not specific tests for prostate cancer screening.
A client with Hashimoto’s thyroiditis and a history of two myocardial infarctions and coronary artery disease is to receive levothyroxine (Synthroid). Because of the client’s cardiac history, the nurse would expect that the client’s initial dose for the thyroid replacement would be which of the following?
- A. 25 g/day, initially
- B. Delayed until after thyroid surgery
- C. 100 g/day, initially
- D. Initiated before thyroid surgery
Correct Answer: A
Rationale: The correct answer is A: 25 g/day, initially. In this scenario, the client with Hashimoto's thyroiditis and a history of cardiac issues requires a cautious approach due to the risk of exacerbating cardiac conditions with thyroid hormone replacement. Starting with a low dose of 25 µg/day allows for careful monitoring of the client's response and prevents potential adverse effects on the cardiovascular system.
Summary:
B: Delayed until after thyroid surgery - Not appropriate as the client requires thyroid replacement therapy for Hashimoto's thyroiditis.
C: 100 µg/day, initially - Too high of an initial dose and may lead to adverse cardiovascular effects.
D: Initiated before thyroid surgery - Not relevant to the client's situation as there is no indication for thyroid surgery mentioned in the question.
The nurse expects to note an elevated serum glucose level in a client with hyperosmolar hyperglycemic nonketonic syndrome (HHNS). Which other laboratory finding should the nurse anticipate?
- A. Elevated serum acetone level
- B. Serum alkalosis
- C. Serum ketone bodies
- D. Below-normal serum potassium level
Correct Answer: D
Rationale: Step 1: In HHNS, there is severe hyperglycemia leading to osmotic diuresis.
Step 2: Osmotic diuresis causes loss of potassium in urine, leading to hypokalemia.
Step 3: Hypokalemia is a common electrolyte imbalance in HHNS due to excessive urinary loss of potassium.
Step 4: Therefore, the nurse should anticipate a below-normal serum potassium level in a client with HHNS.
Summary:
A: Elevated serum acetone level is seen in diabetic ketoacidosis, not HHNS.
B: Serum alkalosis is not typically associated with HHNS.
C: Serum ketone bodies are elevated in diabetic ketoacidosis, not HHNS.
Which of the ff finding would confirm that a female client has mastitis? Choose all that apply
- A. A crack in the nipple or the areola
- B. Multiple lumps within the breast tissue
- C. Swollen, firm, and hard breasts
- D. Enlargement of the axillary lymph nodes
Correct Answer: C
Rationale: The correct answer is C because mastitis typically presents with swollen, firm, and hard breasts due to inflammation and infection of the breast tissue. This occurs as a result of milk stasis and bacterial infection. Option A is incorrect because a crack in the nipple or areola can be indicative of nipple trauma or infection, not necessarily mastitis. Option B is incorrect because multiple lumps within the breast tissue may suggest fibrocystic changes or breast cancer, but not specifically mastitis. Option D is incorrect because enlargement of the axillary lymph nodes is more commonly seen in breast cancer, not mastitis.
Which of the ff. is the best explanation of emphysema for a newly diagnosed patient?
- A. “You have inflamed bronchioles, which causes a lot of secretions.”
- B. “Your lungs have lost some of their elasticity, and air gets trapped.”
- C. “The blood supply to your lungs is damaged, so you can’t absorb oxygen.”
- D. “You have large dilated sacs of sputum in your lungs.”
Correct Answer: B
Rationale: The correct answer is B because emphysema is characterized by the destruction of the alveoli walls, leading to a loss of elasticity in the lungs. This results in air becoming trapped in the lungs, making it difficult to exhale properly.
Explanation for why the other choices are incorrect:
A: Inflamed bronchioles causing secretions describe bronchitis, not emphysema.
C: Damage to the blood supply isn't a primary feature of emphysema; it's more about lung tissue destruction.
D: Large dilated sacs of sputum in the lungs is not an accurate description of emphysema; it's more related to bronchiectasis.