Nokea
The patient is taking hydrochlorothiazide (HydroDIURIL) and digoxin (Lanoxin). Which potential electrolyte imbalance will the nurse monitor for in this patient?
- A. Hypermagnesemia
- B. Hypernatremia
- C. Hypocalcemia
- D. Hypokalemia
Correct Answer: D
Rationale: The correct answer is D: Hypokalemia. Thiazide diuretics like hydrochlorothiazide can cause hypokalemia. Hypokalemia enhances the effects of digoxin, leading to digoxin toxicity. Thiazides can also cause hypercalcemia. Choices A, B, and C are incorrect. Hypermagnesemia is not typically associated with hydrochlorothiazide use. Hypernatremia and hypocalcemia are not the primary electrolyte imbalances to monitor for in this scenario.
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A client with polycystic kidney disease (PKD) is being discharged. Which statements should the nurse include in this client's discharge teaching? (Select all that apply.)
- A. Take your blood pressure every morning.
- B. Weigh yourself at the same time each day.
- C. Contact your provider if you have visual disturbances.
- D. All of the above
Correct Answer: D
Rationale: A client with polycystic kidney disease (PKD) should be educated on monitoring their blood pressure daily and weighing themselves consistently to detect any changes promptly. It is essential to contact the healthcare provider if visual disturbances occur, as this could indicate a complication such as a berry aneurysm associated with PKD. Foul-smelling or bloody urine should also prompt notification to the provider as they could signify urinary tract infections or glomerular injury. Choices A, B, and C are correct as they address crucial aspects of managing PKD and its potential complications. Choices A and B help in monitoring for changes in blood pressure and fluid status, while choice C focuses on detecting possible neurological complications. Choices A, B, and C are relevant to PKD management and should be included in the client's discharge teaching. Choices that mention diarrhea and renal stones are not directly associated with PKD; therefore, teaching related to these conditions would be irrelevant in this context.
A client with renal insufficiency and a low red blood cell count asks, 'Is my anemia related to the renal insufficiency?' How should the nurse respond?
- A. Red blood cells produce erythropoietin, which increases blood flow to the kidneys.
- B. Your anemia and renal insufficiency are related to inadequate vitamin D and a loss of bone density.
- C. Erythropoietin is usually released from the kidneys and stimulates red blood cell production in the bone marrow.
- D. Kidney insufficiency inhibits active transportation of red blood cells throughout the blood.
Correct Answer: C
Rationale: The correct answer is C. Erythropoietin is produced in the kidney and is released in response to decreased oxygen tension in the renal blood supply. Erythropoietin stimulates red blood cell production in the bone marrow. Anemia in renal insufficiency is often due to decreased erythropoietin production. Anemia and renal insufficiency are not manifestations of vitamin D deficiency as stated in choice B. Choice A is incorrect as erythropoietin does not increase blood flow to the kidneys. Choice D is incorrect because kidney insufficiency does not inhibit active transportation of red blood cells throughout the blood; rather, it affects erythropoietin production and subsequent red blood cell formation.
A client is experiencing diarrhea. For which acid-base disorder should the nurse assess the client?
- A. Metabolic acidosis
- B. Metabolic alkalosis
- C. Respiratory acidosis
- D. Respiratory alkalosis
Correct Answer: A
Rationale: When a client experiences diarrhea, the loss of bicarbonate-rich fluids from the body leads to a decrease in the bicarbonate levels in the blood, resulting in metabolic acidosis. Metabolic alkalosis (choice B) is characterized by an increase in bicarbonate levels, which is not typically associated with diarrhea. Respiratory acidosis (choice C) is caused by retention of carbon dioxide, while respiratory alkalosis (choice D) results from excessive exhalation of carbon dioxide, neither of which are directly related to diarrhea. Therefore, the correct answer is metabolic acidosis (choice A) in the context of diarrhea.
After teaching a client with renal cancer who is prescribed temsirolimus (Torisel), the nurse assesses the client's understanding. Which statement made by the client indicates a correct understanding of the teaching?
- A. I will take this medication with food and plenty of water.
- B. I shall keep my appointment at the infusion center each week.
- C. I'll limit my intake of green leafy vegetables while on this medication.
- D. I must not take this medication if I have an infection or am feeling ill.
Correct Answer: B
Rationale: The correct answer is B. Temsirolimus, also known as Torisel, is administered as a weekly intravenous infusion. This medication blocks protein needed for cell division, inhibiting cell cycle progression. It is not taken orally, so there is no need to take it with food or water. Keeping the weekly infusion center appointment is crucial for the client to receive the prescribed treatment effectively. Choice A is incorrect as temsirolimus is not taken with food or water. Choice C is incorrect because there is no need to limit the intake of green leafy vegetables while on this medication. Choice D is incorrect as having an infection or feeling ill does not prohibit the use of temsirolimus.
A client with diabetes mellitus is scheduled to have blood drawn for a fasting blood glucose determination in the morning. What does the nurse tell the client is acceptable to consume on the morning of the test?
- A. Water
- B. Tea without sugar
- C. Coffee without milk
- D. Clear liquids like apple juice
Correct Answer: A
Rationale: The correct answer is A: Water. A client scheduled for a fasting blood glucose test should only consume water after midnight to ensure accurate test results. Choosing options B, C, or D, which include tea, coffee, or clear liquids like apple juice, is incorrect as they may contain substances that can affect the blood glucose levels, leading to inaccurate test results.