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What is the most appropriate nursing intervention to help alleviate severe abdominal pain in a patient with acute pancreatitis?
- A. Encourage oral intake of clear fluids.
- B. Place the patient in a supine position.
- C. Administer prescribed opioid analgesics.
- D. Apply a heating pad to the abdomen.
Correct Answer: C
Rationale: The correct answer is C, administering prescribed opioid analgesics. This intervention is appropriate for severe abdominal pain in acute pancreatitis as opioids are effective in managing pain. Encouraging oral intake (A) can worsen symptoms, a supine position (B) can exacerbate pain, and a heating pad (D) can aggravate inflammation. Administering opioid analgesics provides direct pain relief and is the most effective intervention for alleviating severe abdominal pain in acute pancreatitis.
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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.
The nurse is administering sevelamer (RenaGel) during lunch to a client with end-stage renal disease (ESRD). The client asks the nurse to bring the medication later. The nurse should describe which action of RenaGel as an explanation for taking it with meals?
- A. Prevents indigestion associated with the ingestion of spicy foods.
- B. Binds with phosphorus in foods and prevents absorption.
- C. Promotes stomach emptying and prevents gastric reflux.
- D. Buffers hydrochloric acid and prevents gastric erosion.
Correct Answer: B
Rationale: The correct answer is B: Binds with phosphorus in foods and prevents absorption. Sevelamer (RenaGel) is a phosphate binder used in ESRD to reduce phosphorus levels. Taking it with meals allows it to bind with phosphorus in food, preventing its absorption in the gastrointestinal tract. This helps in controlling hyperphosphatemia, a common complication in ESRD. Choices A, C, and D are incorrect as RenaGel does not prevent indigestion, promote stomach emptying, or buffer hydrochloric acid.
A patient with bipolar disorder is prescribed lithium. What dietary advice should the nurse provide?
- A. Increase intake of caffeine.
- B. Maintain a consistent salt intake.
- C. Avoid dairy products.
- D. Increase intake of green leafy vegetables.
Correct Answer: B
Rationale: The correct answer is B: Maintain a consistent salt intake. Lithium can affect sodium levels in the body, so it's important to maintain a consistent salt intake to prevent lithium toxicity or imbalance. Increasing caffeine intake (choice A) can worsen symptoms of bipolar disorder. Avoiding dairy products (choice C) is not necessary for lithium therapy. Increasing intake of green leafy vegetables (choice D) is generally healthy but not specifically recommended for lithium therapy. Maintaining a consistent salt intake is crucial in managing the effects of lithium on sodium levels.
In a patient with chronic kidney disease (CKD) receiving erythropoietin therapy, what laboratory result should the nurse monitor to evaluate the effectiveness of this therapy?
- A. Serum creatinine
- B. White blood cell count
- C. Hemoglobin level
- D. Serum potassium
Correct Answer: C
Rationale: Rationale: The correct answer is C, hemoglobin level. Erythropoietin therapy is used to stimulate red blood cell production in CKD patients with anemia. Monitoring hemoglobin levels helps assess the effectiveness of the therapy in improving anemia. If hemoglobin levels increase, it indicates the therapy is working.
Summary of incorrect choices:
A: Serum creatinine - This measures kidney function, not the effectiveness of erythropoietin therapy for anemia in CKD patients.
B: White blood cell count - Monitors immune function, not related to erythropoietin therapy for anemia.
D: Serum potassium - Important for monitoring electrolyte balance in CKD patients but not specific to assessing erythropoietin therapy effectiveness.
A patient with asthma is prescribed a corticosteroid inhaler. What is the most important instruction to give to the patient?
- A. Use the inhaler only during asthma attacks.
- B. Rinse the mouth after using the inhaler.
- C. Take a double dose if symptoms worsen.
- D. Avoid using a spacer with the inhaler.
Correct Answer: B
Rationale: The correct answer is B: Rinse the mouth after using the inhaler. This instruction is crucial because corticosteroid inhalers can lead to oral thrush, a fungal infection in the mouth. Rinsing the mouth helps prevent this side effect.
A: Using the inhaler only during asthma attacks is incorrect as corticosteroid inhalers are typically used regularly to manage asthma symptoms.
C: Taking a double dose if symptoms worsen is dangerous and can lead to overdose. Patients should follow the prescribed dosage.
D: Avoiding using a spacer with the inhaler is not a universal instruction. Spacers can actually improve the effectiveness of the medication delivery.