Nokea
The physician is assessing renal function in a client with severe pancreatitis. Which laboratory finding would be the best indicator of a problem in this area?
- A. Alkaline phosphatase 20U/L
- B. Hemoglobin 14.6 g/dL
- C. BUN 28 mg/dL
- D. Creatinine 2.3 mg/dL
Correct Answer: D
Rationale: Creatinine is the most specific laboratory test for renal functioning; normal is 0.5-1.5 mg/dL. Answers A and B do not relate to the kidney, so they are incorrect. Answer C can be abnormal with kidney function but is not as specific as the creatinine, so it's incorrect.
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The nurse is caring for clients on the neurology unit.
- A. What is the most appropriate action for the nurse to take after noting a client suddenly developed a fixed and dilated pupil?
- B. Reassess in five minutes.
- C. Check the client’s visual acuity.
- D. Lower the head of the client’s bed.
- E. Contact the physician.
Correct Answer: D
Rationale: A fixed and dilated pupil is a neurological emergency, often indicating increased intracranial pressure or brain herniation. Immediate physician notification is critical to initiate interventions. Reassessing later delays care, checking visual acuity is irrelevant, and lowering the bed could worsen intracranial pressure.
Because a client is taking rifampin (Rimactane), what must the nurse include when discussing medications with the client?
- A. Report any changes in hearing immediately because this is a common side effect.
- B. You should be taking vitamin B6 to prevent painful neuritis.
- C. If your big toes become painful, you must tell the physician.
- D. Your perspiration and urine may turn red-orange.
Correct Answer: D
Rationale: Rifampin commonly causes red-orange discoloration of urine and sweat, a harmless side effect clients should be informed about to avoid alarm.
An obstetrical client elects to have epidural anesthesia with Marcaine. After the epidural anesthesia is given, the nurse should monitor the client for signs of:
- A. Seizure activity
- B. Respiratory depression
- C. Postural hypotension
- D. Hematuria
Correct Answer: C
Rationale: Marcaine (bupivacaine) can cause vasodilation, leading to postural hypotension. Seizures, respiratory depression, and hematuria are less common.
The nurse is caring for an adult who has kidney stones. Which action is essential for the nurse to take?
- A. Take blood pressure frequently
- B. Keep the client on bed rest
- C. Position the client supine
- D. Strain all urine
Correct Answer: D
Rationale: Straining urine captures kidney stones for analysis, guiding treatment. Blood pressure, bed rest, or positioning are not primary.
A nurse is assessing a patient in the rehab unit at shift change. The patient has suffered a TBI 3 weeks ago. Which of the following is the most distinguishing characteristic of a neurological disturbance?
- A. LOC (level of consciousness)
- B. Short term memory
- C. #NAME?
- D. #NAME?
Correct Answer: A
Rationale: LOC is the most critical indicator of impaired neurological capabilities.