Nokea
What is the most appropriate response when a client with chronic kidney disease asks about fluid restrictions?
- A. Fluid restrictions are not needed for all clients with chronic kidney disease.
- B. You may need to limit fluid intake to prevent fluid overload.
- C. Fluid restrictions are based on your lab results and daily weights.
- D. Restricting fluids is only necessary during dialysis.
Correct Answer: B
Rationale: The most appropriate response when a client with chronic kidney disease asks about fluid restrictions is to inform them that limiting fluid intake may be necessary to prevent fluid overload. This is crucial in managing the condition and preventing complications such as edema and electrolyte imbalances. Choice A is incorrect as fluid restrictions are commonly advised for clients with chronic kidney disease. Choice C is partially correct as fluid restrictions are indeed based on lab results and daily weights, but the primary goal is to prevent fluid overload. Choice D is incorrect because fluid restrictions are not limited to just during dialysis; they are often recommended throughout the day to manage the condition.
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How should a healthcare professional manage a patient with congestive heart failure?
- A. Administer diuretics and monitor fluid balance
- B. Provide a high-sodium diet and restrict fluids
- C. Administer oxygen and provide pain relief
- D. Provide bronchodilators and encourage mobility
Correct Answer: A
Rationale: Correct answer: The most appropriate management for a patient with congestive heart failure is to administer diuretics to help remove excess fluid and monitor fluid balance. Diuretics help reduce the workload on the heart and alleviate symptoms of fluid overload. Choice B is incorrect because patients with congestive heart failure are usually advised to limit sodium intake and carefully monitor fluid intake. Choice C is incorrect because although oxygen therapy may be necessary in certain cases, it is not the primary management for congestive heart failure. Pain relief is not a primary intervention for this condition. Choice D is incorrect because bronchodilators are not the first-line treatment for congestive heart failure. Encouraging mobility is important, but administering diuretics and monitoring fluid balance take precedence in managing this condition.
Which instruction is crucial for a client with diabetes being discharged?
- A. Take insulin only when feeling unwell
- B. Administer insulin before meals as prescribed
- C. Monitor blood sugar levels weekly
- D. Check blood sugar once in the morning
Correct Answer: B
Rationale: Administering insulin before meals as prescribed is crucial for a client with diabetes being discharged because it ensures proper blood sugar control. Choice A is incorrect because insulin should not be taken only when feeling unwell; it should be taken as prescribed. Choice C is incorrect as monitoring blood sugar levels weekly may not provide timely adjustments to insulin doses. Choice D is incorrect as checking blood sugar only once in the morning is not sufficient for proper diabetes management.
A client with a tracheostomy is exhibiting signs of respiratory distress. What is the nurse's immediate priority?
- A. Increase the oxygen flow rate
- B. Suction the tracheostomy
- C. Notify the physician immediately
- D. Administer a bronchodilator
Correct Answer: B
Rationale: When a client with a tracheostomy is experiencing respiratory distress, the immediate priority for the nurse is to suction the tracheostomy. This action helps clear the airway of secretions and ensures that the client can breathe effectively. Increasing the oxygen flow rate may be necessary but addressing the airway obstruction is more critical. Notifying the physician immediately is important but may cause a delay in addressing the immediate need for airway clearance. Administering a bronchodilator may help with bronchospasm but should not take precedence over ensuring a clear airway in a client with respiratory distress.
What are the signs and symptoms of opioid withdrawal, and how should they be managed?
- A. Nausea, sweating, and increased heart rate; manage with methadone
- B. Pain and restlessness; manage with naloxone
- C. Hallucinations and muscle cramps; manage with clonidine
- D. Severe vomiting and seizures; manage with benzodiazepines
Correct Answer: A
Rationale: The signs and symptoms of opioid withdrawal include nausea, sweating, and increased heart rate. Methadone is commonly used to manage opioid withdrawal symptoms by alleviating them. Choice B, managing with naloxone, is incorrect as naloxone is primarily used for opioid overdose reversal, not withdrawal. Choice C, managing with clonidine, is incorrect as clonidine is used to manage some symptoms of withdrawal, such as anxiety, agitation, and hypertension, but not hallucinations. Choice D, managing with benzodiazepines, is incorrect as benzodiazepines are not typically used as first-line treatment for opioid withdrawal; they may be considered in specific cases but are not a standard approach.
A nurse manager is discussing the responsibility of nurses caring for clients who have Clostridium difficile. Which of the following information should the nurse include in the teaching?
- A. Assign the client to a room with a negative air-flow system
- B. Use alcohol-based hand sanitizer when leaving the client's room
- C. Clean contaminated surfaces in the client's room with a phenol solution
- D. Have family members wear a gown and gloves when visiting
Correct Answer: D
Rationale: The correct answer is D because having family members wear a gown and gloves when visiting a client with Clostridium difficile is essential to prevent the spread of infection. Options A, B, and C are incorrect. Negative air-flow systems are not necessary for preventing the spread of C. difficile. While alcohol-based hand sanitizers are effective for routine hand hygiene, they may not be sufficient for C. difficile. Cleaning contaminated surfaces with a phenol solution is not the most effective method for preventing the spread of C. difficile, as spores can be resistant to many disinfectants.