Nokea
What is the nurse's priority when caring for a client experiencing acute renal failure?
- A. Administer IV fluids
- B. Monitor vital signs closely
- C. Perform a kidney function test
- D. Administer IV antibiotics
Correct Answer: A
Rationale: The correct answer is A: Administer IV fluids. In acute renal failure, the priority is to maintain adequate hydration to support kidney function. IV fluids help improve renal perfusion and urine output. Monitoring vital signs is important but not the priority. Performing a kidney function test can provide valuable information but does not address the immediate need for fluid resuscitation. Administering IV antibiotics may be necessary if there is an infection contributing to renal failure, but hydration takes precedence. In summary, administering IV fluids is crucial to support kidney function in acute renal failure, making it the top priority among the choices given.
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A 47-year-old woman who is a recent immigrant to Canada is being seen at the clinic today for her uncontrolled diabetes. The nurse knows that the patient lives with her husband and a large extended family. The nurse concludes that part of the patient's inability to maintain and comply with her diet and diabetic regime is the foods that this patient eats. This conclusion is an example of:
- A. cultural sensitivity.
- B. cultural safety.
- C. cultural perspective.
- D. culturalism.
Correct Answer: D
Rationale: The correct answer is D: culturalism. The nurse's conclusion that the patient's inability to maintain her diet and diabetic regime is due to the foods she eats reflects culturalism. Culturalism refers to the belief that a person's behaviors and beliefs are solely determined by their culture. In this case, the nurse is attributing the patient's struggles solely to her cultural background without considering other factors.
A: Cultural sensitivity is about being aware and respectful of different cultures, but it does not involve making assumptions based on culture alone.
B: Cultural safety is about creating a safe and respectful environment for individuals from different cultures, but it does not involve making assumptions about behavior solely based on culture.
C: Cultural perspective involves understanding different cultural viewpoints, but it does not involve making assumptions about behavior solely based on culture.
In summary, the nurse's conclusion is an example of culturalism as it oversimplifies the patient's situation by attributing her struggles solely to her cultural background.
A nurse is caring for a patient with hypertension. The nurse should monitor for which of the following complications?
- A. Heart failure.
- B. Chronic kidney disease.
- C. Stroke.
- D. All of the above.
Correct Answer: D
Rationale: The correct answer is D. Hypertension can lead to various complications affecting the heart, kidneys, and brain. Monitoring for heart failure is crucial due to the increased workload on the heart. Chronic kidney disease is a common complication of hypertension, as the kidneys are sensitive to changes in blood pressure. Stroke is another significant risk due to the potential damage to blood vessels in the brain. Therefore, monitoring for all these complications is essential in managing a patient with hypertension. Other choices are incorrect as they do not encompass all possible complications of hypertension.
In response to a question about use of alcohol, a patient asks the nurse why the nurse needs that information. What reason would the nurse give the patient?
- A. This is necessary to determine the patient's reliability.
- B. Alcohol can interact with medications and can make some diseases worse.
- C. The nurse is required to teach the patient about the dangers of alcohol use.
- D. It is not really necessary to ask for this information unless there is an obvious drinking problem.
Correct Answer: B
Rationale: The correct answer is B because alcohol can interact with medications and exacerbate certain medical conditions. The nurse needs this information to ensure the patient's safety and well-being. Choice A is incorrect because the question is not about the patient's reliability. Choice C is incorrect as it assumes the nurse is required to educate the patient about alcohol dangers. Choice D is incorrect because even without an obvious drinking problem, alcohol use can still impact the patient's health.
What instructions should the nurse give to a client undergoing mammography?
- A. Be sure to use underarm deodorant
- B. Do not use underarm deodorant
- C. Do not eat or drink after midnight
- D. Have a friend drive you home
Correct Answer: B
Rationale: The correct answer is B: Do not use underarm deodorant. This is important because deodorant can interfere with the mammogram results, leading to false readings. It is crucial to have a clean and uncontaminated image for an accurate diagnosis. Choice A is incorrect as it can affect the quality of the mammogram. Choices C and D are irrelevant to the mammography procedure and not necessary instructions for the client.
What is the most important assessment for a client who has been receiving chemotherapy for several weeks?
- A. Check for signs of infection
- B. Monitor the client's weight
- C. Monitor the client's nutrition
- D. Check for skin changes
Correct Answer: A
Rationale: The correct answer is A: Check for signs of infection. This is crucial because chemotherapy weakens the immune system, increasing the risk of infections. Signs of infection such as fever, chills, sore throat, and cough should be closely monitored to prevent serious complications. Monitoring weight (B) and nutrition (C) are important but not as critical as detecting infections promptly. Checking for skin changes (D) is also important, but it is secondary to identifying and managing infections due to the immediate threat they pose to the client's health.