Nokea
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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A client with a new diagnosis of myasthenia gravis is prescribed pyridostigmine (Mestinon). Which instruction should the nurse include in the client's teaching?
- A. Take the medication with food to prevent gastrointestinal upset.
- B. Take the medication 30 minutes before meals.
- C. Avoid dairy products while taking this medication.
- D. Take the medication at bedtime.
Correct Answer: B
Rationale: The correct answer is B: Take the medication 30 minutes before meals. Pyridostigmine is a cholinesterase inhibitor used to treat myasthenia gravis by improving muscle strength. Taking it before meals helps optimize its effects when muscle strength is needed the most during eating. Taking it with food (A) may delay absorption. Avoiding dairy products (C) is not necessary with pyridostigmine. Taking the medication at bedtime (D) may not be optimal for addressing muscle weakness during meal times.
What is the primary cause of jaundice in a client with liver cirrhosis?
- A. Decreased bile production
- B. Increased bilirubin levels
- C. Hepatic inflammation
- D. Portal hypertension
Correct Answer: B
Rationale: The primary cause of jaundice in a client with liver cirrhosis is increased bilirubin levels. Liver cirrhosis impairs the liver's ability to process bilirubin, leading to its accumulation in the bloodstream. This excess bilirubin then causes the yellow discoloration of the skin and eyes characteristic of jaundice.
Incorrect Choices:
A: Decreased bile production is not the primary cause of jaundice in liver cirrhosis. While decreased bile flow may contribute to jaundice, it is secondary to the impaired bilirubin processing.
C: Hepatic inflammation is a common feature of liver cirrhosis but is not the direct cause of jaundice in this context.
D: Portal hypertension is a complication of liver cirrhosis but is not the primary cause of jaundice.
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.
A client is admitted with diabetic ketoacidosis (DKA). Which assessment finding requires immediate intervention?
- A. Fruity breath odor.
- B. Blood glucose of 450 mg/dL.
- C. Deep, rapid respirations.
- D. Serum potassium of 5.2 mEq/L.
Correct Answer: C
Rationale: Step-by-step rationale:
1. Deep, rapid respirations in DKA indicate Kussmaul respirations, a compensatory mechanism for metabolic acidosis.
2. Immediate intervention is needed to prevent respiratory failure and further acidosis.
3. Administering IV fluids and insulin can help correct acidosis and stabilize breathing.
4. Fruity breath odor (A) and high blood glucose (B) are common in DKA but do not require immediate intervention.
5. Serum potassium of 5.2 mEq/L (D) is slightly elevated but not as urgent as addressing respiratory distress.
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.