Nokea
The physician orders high protein, high calorie and high salt diet on Valerie.
When ask by the patient, the nurse would explain that
- A. high salt diet replaces potassium loss in the urine.
- B. high protein, high calorie diet is needed for tissue repair and energy expenditure.
- C. high protein and high calorie diet is important in gaining weight.
- D. extra salt is needed to increase the low sodium level in Addison's disease.
Correct Answer: D
Rationale: Lack of mineralcorticoids (aldosterone) leads to a loss of sodium ions in the urine and subsequent hyponatremia, necessitating a high salt diet.
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Two days postpartum a patient who had a C-section delivery complains of pain in the right leg.
The nurse should instruct the patient to
- A. apply warm compresses.
- B. massage the affected area.
- C. encourage range of motion exercises to promote circulation.
- D. maintain bed rest and notifies the physician.
Correct Answer: D
Rationale: Leg pain post-C-section may indicate a deep vein thrombosis, requiring bed rest and physician notification.
Which client is at highest risk for developing a pressure ulcer?
- A. 23 year-old in traction for fractured femur
- B. 72 year-old with peripheral vascular disease, who is unable to walk without assistance
- C. 75 year-old with left sided paresthesia who is incontinent of urine and stool
- D. 30 year-old who is comatose following a ruptured aneurysm
Correct Answer: C
Rationale: 75 year-old with left sided paresthesia who is incontinent of urine and stool. Risk factors for pressure ulcers include: immobility, absence of sensation, decreased LOC, poor nutrition and hydration, skin moisture, incontinence, increased age, decreased immune response. This client has the greatest number of risk factors.
A nurse is caring for a patient with diabetes mellitus who is scheduled for surgery. Which of the following is the most important preoperative assessment?
- A. Blood glucose level.
- B. Electrolyte levels.
- C. Complete blood count (CBC).
- D. Urinalysis.
Correct Answer: A
Rationale: Blood glucose control is critical preoperatively in diabetes to prevent complications like wound infections or ketoacidosis. Electrolytes, CBC, and urinalysis are important but secondary, as glucose directly impacts surgical outcomes.
Which of the following lab reports indicates that a client with acute glomerulonephritis is improving?
- A. Positive ASO titer
- B. Increased C reactive protein
- C. Negative eosinophil count
- D. Decreased erythrocyte sedimentation rate
Correct Answer: D
Rationale: A decreased erythrocyte sedimentation rate indicates reduced inflammation, suggesting improvement in acute glomerulonephritis.
A 69-year-old woman has a history of heart failure. She is admitted to the emergency department with heart failure complicated by pulmonary edema.
On admission of this patient, which of the following should be assessed first?
- A. blood pressure
- B. skin breakdown
- C. serum potassium
- D. urine output
Correct Answer: A
Rationale: Blood pressure assessment is critical in pulmonary edema to guide treatment and assess cardiovascular status.