Nokea
What is a key nursing intervention for a client receiving peritoneal dialysis?
- A. Monitor for signs of peritonitis.
- B. Restrict protein intake.
- C. Administer anticoagulants.
- D. Limit ambulation.
Correct Answer: A
Rationale: Peritonitis is a serious complication of peritoneal dialysis, requiring vigilant monitoring.
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A client comes to the health clinic 3 years after undergoing a resection of the terminal ileum and tells the nurse that he has weakness, shortness of breath, and a sore tongue. Which client statement indicates a need for intervention and client teaching?
- A. I have been drinking plenty of fluids.'
- B. I have been gargling with warm salt water for my sore tongue.'
- C. I have three to four loose stools per day.'
- D. I take a vitamin B12 tablet every day.'
Correct Answer: D
Rationale: Resection of the terminal ileum impairs vitamin B12 absorption, as the ileum is the primary site for B12 uptake. The client's symptoms (weakness, shortness of breath, sore tongue) suggest B12 deficiency, likely due to inadequate absorption of oral B12 supplements. The statement about taking a B12 tablet daily indicates a need for intervention, as the client may require intramuscular B12 injections. The other statements are appropriate or expected (loose stools are common post-resection).
If the client who was admitted for myocardial infarction (MI) develops cardiogenic shock, which characteristic sign should the nurse expect to observe?
- A. Oliguria.
- B. Bradycardia.
- C. Elevated blood pressure.
- D. Fever.
Correct Answer: A
Rationale: Cardiogenic shock causes decreased cardiac output, leading to reduced renal perfusion and oliguria (low urine output). Bradycardia, elevated BP, and fever are not typical signs.
A client has a chest tube attached to a waterseal drainage system and the nurse notes that the fluid in the chest tube and in the water-seal column has stopped fluctuating. The nurse should determine:
- A. The lung has fully expanded.
- B. The lung has collapsed.
- C. The chest tube is in the pleural space.
- D. The mediastinal space has decreased.
Correct Answer: A
Rationale: Lack of fluctuation in the water-seal column suggests the lung has fully expanded, resolving the pneumothorax. Collapsed lung, tube placement, or mediastinal changes would show other signs.
A client developed shock after a severe myocardial infarction and has now developed acute renal failure. The nurse should base the response on the knowledge that there was:
- A. A decrease in the blood flow through the kid-
- B. An obstruction of urine flow from the kidneys.
- C. A blood clot formed in the kidneys.
- D. A structural damage to the kidney resulting in acute tubular necrosis.
Correct Answer: A
Rationale: Decreased renal blood flow from shock post-myocardial infarction reduces kidney perfusion, leading to acute renal failure.
Lifestyle influences that are considered risk factors for colorectal cancer include:
- A. A diet low in vitamin C.
- B. A high dietary intake of artificial sweeteners (Aspartame).
- C. A high-fat, low-fiber diet.
- D. Multiple sex partners.
Correct Answer: C
Rationale: A high-fat, low-fiber diet is a well-established risk factor for colorectal cancer, as it slows digestion and increases exposure to potential carcinogens in the colon.