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What instruction should a patient with a history of hypertension be provided when being discharged with a prescription for a thiazide diuretic?
- A. Avoid foods high in potassium.
- B. Take the medication at bedtime.
- C. Monitor weight daily.
- D. Limit fluid intake to 1 liter per day.
Correct Answer: C
Rationale: Rationale:
C is correct because thiazide diuretics can cause fluid retention, leading to weight gain, which may indicate worsening heart failure or hypertension. Daily weight monitoring helps detect fluid retention early, enabling timely intervention.
Summary:
A: Incorrect. Thiazide diuretics can cause potassium loss, so avoiding potassium-rich foods is not necessary.
B: Incorrect. Taking the medication in the morning is preferred to prevent nocturia and sleep disturbances.
D: Incorrect. Fluid intake should not be limited unless advised by a healthcare provider to prevent dehydration.
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The patient admitted with diabetic ketoacidosis has rapid, deep respirations. What action should the nurse take?
- A. Administer the prescribed PRN lorazepam (Ativan).
- B. Start the prescribed PRN oxygen at 2 to 4 L/min.
- C. Administer the prescribed normal saline bolus and insulin.
- D. Encourage the patient to practice guided imagery for relaxation.
Correct Answer: C
Rationale: The correct answer is C, administer the prescribed normal saline bolus and insulin. In diabetic ketoacidosis, rapid, deep respirations, known as Kussmaul breathing, occur due to compensatory mechanisms to lower blood pH. Normal saline bolus helps correct dehydration and insulin therapy helps lower blood sugar levels, leading to improved acidosis. Option A is incorrect as lorazepam does not address the underlying cause of the rapid respirations. Option B is incorrect as oxygen is not the priority in this situation. Option D is incorrect as guided imagery does not address the physiological needs of the patient in this critical condition.
A patient with anemia is prescribed ferrous sulfate. What advice should the nurse give regarding the administration of this medication?
- A. Take with dairy products to increase absorption.
- B. Take on an empty stomach for best absorption.
- C. Avoid vitamin C while taking this medication.
- D. Take before bedtime.
Correct Answer: B
Rationale: The correct answer is B: Take on an empty stomach for best absorption. Ferrous sulfate is best absorbed on an empty stomach to maximize its effectiveness. When taken with food or dairy products (Choice A), the absorption of iron is reduced. Vitamin C actually enhances the absorption of iron, so avoiding it (Choice C) is not recommended. Taking the medication before bedtime (Choice D) may lead to gastrointestinal side effects and is not optimal for absorption.
The healthcare professional is caring for a client with heart failure who is receiving digoxin (Lanoxin). Which assessment finding requires immediate intervention?
- A. Heart rate of 58 beats per minute.
- B. Nausea and vomiting.
- C. Blood pressure of 130/80 mm Hg.
- D. Shortness of breath.
Correct Answer: B
Rationale: The correct answer is B: Nausea and vomiting. This finding requires immediate intervention because digoxin toxicity can present with gastrointestinal symptoms like nausea and vomiting. This can indicate an overdose of digoxin, which can be life-threatening. Prompt action is necessary to prevent further complications.
A: Heart rate of 58 beats per minute is within the therapeutic range for digoxin and does not require immediate intervention.
C: Blood pressure of 130/80 mm Hg is also within normal limits and does not indicate an urgent issue.
D: Shortness of breath can be a symptom of heart failure but is not a direct indication of digoxin toxicity requiring immediate intervention.
The healthcare provider in the outpatient clinic has obtained health histories for these new patients. Which patient may need referral for genetic testing?
- A. 35-year-old patient whose maternal grandparents died after strokes at ages 90 and 96
- B. 18-year-old patient with a positive pregnancy test whose first child has cerebral palsy
- C. 34-year-old patient who has a sibling with newly diagnosed polycystic kidney disease
- D. 50-year-old patient with a history of cigarette smoking who is complaining of dyspnea
Correct Answer: C
Rationale: The correct answer is C. The patient with a sibling having newly diagnosed polycystic kidney disease may need a referral for genetic testing. Polycystic kidney disease has a genetic component, so there is a higher likelihood of the patient also having the condition. Referral for genetic testing can help in early diagnosis, management, and counseling for the patient and their family members.
Choice A is incorrect because strokes in maternal grandparents at advanced ages are not typically indicative of a need for genetic testing. Choice B is incorrect as cerebral palsy is not typically a genetic condition related to the patient's pregnancy test result. Choice D is incorrect as dyspnea in a smoking patient is more likely related to respiratory issues such as chronic obstructive pulmonary disease rather than a genetic condition.
When implementing patient teaching for a patient admitted with hyperglycemia and newly diagnosed diabetes mellitus scheduled for discharge the second day after admission, what is the priority action for the nurse?
- A. Instruct about the increased risk for cardiovascular disease.
- B. Provide detailed information about dietary control of glucose.
- C. Teach glucose self-monitoring and medication administration.
- D. Give information about the effects of exercise on glucose control.
Correct Answer: C
Rationale: The correct answer is C because teaching glucose self-monitoring and medication administration is the priority action to ensure the patient can manage their condition effectively post-discharge. This step is crucial for immediate management of hyperglycemia and newly diagnosed diabetes mellitus. Option A is incorrect as addressing cardiovascular risk can be important but not the immediate priority. Option B is important but not as urgent as self-monitoring and medication administration. Option D is also important for long-term management but not as critical as ensuring immediate control of blood glucose levels through monitoring and medication.