Nokea
The primary teaching for a client following an extracorporeal shock-wave lithotripsy (ESWL) procedure is
- A. Drink 3000 to 4000 cc of fluid each day for one month.'
- B. Limit fluid intake to 1000 cc each day for one month.'
- C. Increase fluid intake for the next three days.'
- D. Restrict milk and dairy products for one month.'
Correct Answer: A
Rationale: Drink 3000 to 4000 cc of fluid each day for one month.' Drinking three to four quarts (3000 to 4000 cc) of fluid each day will aid passage of fragments and help prevent formation of new calculi.
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When planning the care for a young adult client diagnosed with anorexia nervosa which of these concerns should the nurse determine to be the priority for long term mobility?
- A. Digestive problems
- B. Amenorrhea
- C. Electrolyte imbalance
- D. Blood disorders
Correct Answer: B
Rationale: Amenorrhea. Changes in reproductive hormones and in thyroid hormones can cause absence of menstruation, called amenorrhea, which contributes to osteoporosis and bone fractures.
A client with stage-four Parkinson's disease.
In developing discharge plans with the family of the client with stage-four Parkinson's disease, it is MOST important for the nurse to include which of the following activities?
- A. Ambulate twice daily.
- B. ROM exercise to all extremities four times a day.
- C. Include activities such as knitting and putting puzzles together.
- D. Encourage and provide writing materials.
Correct Answer: B
Rationale: Strategy: All answers are implementations. Determine the outcome of each answer choice. Is it desired? (1) client would be unable to ambulate (2) correct-in stage four Parkinson's disease, client is immobile (3) client cannot perform activities that require small-muscle dexterity (4) client cannot perform activities that require small-muscle dexterity
The nurse is caring for a client after dental surgery. The dentist has prescribed ibuprofen (Motrin IB) 600 mg PO. The nurse would be MOST concerned if the client made which of the following statements?
- A. I was treated for a peptic ulcer two years ago.
- B. I had a transurethral resection of the prostate (TURP) last year.
- C. I attend Weight Watchers.
- D. I have been having problems with gout.
Correct Answer: A
Rationale: Ibuprofen risks gastroinTest inal bleeding in clients with a peptic ulcer history. Options B, C, and D are not contraindications.
The nurse is caring for a client with a history of leukemia.
- A. Which laboratory finding is most concerning for a client with leukemia?
- B. White blood cell count of 50,000/mm³.
- C. Platelet count of 20,000/mm³.
- D. Hemoglobin of 11.0 g/dL.
- E. Serum potassium of 4.0 mEq/L.
Correct Answer: B
Rationale: A platelet count of 20,000/mm³ indicates severe thrombocytopenia, risking life-threatening bleeding in leukemia. Elevated WBC is expected, low hemoglobin is common, and normal potassium is unremarkable.
The nurse on postpartum is preparing four clients for discharge. It would be MOST important for the nurse to refer which of the following clients for homecare?
- A. A 15-year-old who vaginally delivered a 7-lb male two days ago.
- B. An 18-year-old multipara who delivered a 9-lb female by cesarean section two days ago.
- C. A 20-year-old multipara who delivered 1 day ago and is complaining of cramping.
- D. A 22-year-old who delivered by cesarean section and is complaining of burning on urination.
Correct Answer: D
Rationale: Burning on urination suggests a urinary tract infection, requiring homecare follow-up. Options A, B, and C are routine postpartum findings.