Nokea
The practical nurse is reinforcing discharge teaching to a client seen for treatment of a second episode of acute gout. Which instructions should be included to prevent future exacerbations? Select all that apply.
- A. Achieve and maintain a healthy weight
- B. Avoid diet sodas
- C. Avoid foods containing protein
- D. Drink plenty of fluids
- E. Restrict alcohol consumption
Correct Answer: A,D,E
Rationale: Healthy weight (A), hydration (D), and limiting alcohol (E) reduce uric acid levels and gout risk. Diet sodas (B) are not directly linked, and avoiding all protein (C) is unnecessary.
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The client with Cushing's disease will most likely exhibit signs of:
- A. Hypokalemia
- B. Hypernatremia
- C. Hypocalcaemia
- D. Hypermagnesemia
Correct Answer: A
Rationale: Cushing's disease causes hypercortisolism, leading to hypokalemia due to increased potassium excretion. Hypernatremia , hypocalcaemia , and hypermagnesemia are not typical in Cushing's disease.
The nurse is talking with a client who has a new prescription for misoprostol to prevent gastric ulcers. Which of the following statements by the client would require follow-up?
- A. I will take this medication with meals and at bedtime.
- B. I plan to use a reliable form of birth control while taking this medication.
- C. I can take this medication with an antacid to prevent an upset stomach.
- D. I should notify my health care provider if I develop black, tarry stools while taking this medication.
Correct Answer: C
Rationale: Taking misoprostol with antacids (C) reduces its efficacy and requires follow-up. Taking with meals (A), using contraception (B), and reporting black stools (D) are correct.
Which of the following are violations of the Health Insurance Portability and Accountability Act regarding confidentiality of privileged health information? Select all that apply.
- A. A pregnancy result is given to a husband without the wife's permission
- B. The client overhears, through a privacy curtain, the nurse call report on someone
- C. The nurse calls the client by first and last name in the public waiting room
- D. The nurse tells the transporting tech that the client has breast cancer
- E. Unlicensed assistive personnel tell the discharged client, 'You take care now.'
Correct Answer: A,C,D
Rationale: Sharing pregnancy results without consent (A), calling names publicly (C), and disclosing a diagnosis to non-care staff (D) violate HIPAA. Overhearing through a curtain (B) is unintentional, and a general farewell (E) is not a violation.
A client diagnosed with heart failure has an 8-hour urine output of 200 mL. What is the nurse's first action?
- A. Auscultate the client's breath sounds
- B. Encourage the client to increase fluid intake
- C. Report the findings to the supervising registered nurse
- D. Start an IV line for diuretic administration
Correct Answer: C
Rationale: Low urine output (200 mL/8 hr) in heart failure suggests worsening fluid retention, requiring immediate reporting to the RN (C). Auscultation (A), fluids (B), and IV diuretics (D) require RN direction.
The nurse admits a 2 year-old child who has had a seizure. Which of the following statement by the child's parent would be important in determining the etiology of the seizure?
- A. He has been taking long naps for a week.'
- B. He has had an ear infection for the past 2 days.'
- C. He has been eating more red meat lately.'
- D. He seems to be going to the bathroom more frequently.'
Correct Answer: B
Rationale: He has had an ear infection for the past 2 days.' Contributing factors to seizures in children include those such as age (more common in first 2 years), infections (late infancy and early childhood), fatigue, not eating properly and excessive fluid intake or fluid retention.