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When the client questions why both drugs are not taken daily, which response by the nurse is best?
- A. The medications are too toxic if taken on a daily basis.
- B. This alternating schedule maintains adrenal function.
- C. Each medication has a prolonged period of action.
- D. Most people cannot tolerate the medications' daily side effects.
Correct Answer: B
Rationale: Alternating methylprednisolone and prednisone helps maintain adrenal function by mimicking natural cortisol rhythms, reducing suppression of the adrenal glands.
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Which problem is the nurse's immediate concern after kidney transplant surgery?
- A. Risk for infection
- B. Fluid overload
- C. Hypotension
- D. Pain management
Correct Answer: A
Rationale: Risk for infection is the immediate concern post-transplant due to immunosuppression, which increases susceptibility to infections.
The male client diagnosed with CKD has received the initial dose of erythropoietin, a biologic response modifier, one (1) week ago. Which complaint by the client indicates the need to notify the health-care provider?
- A. The client complains of flu-like symptoms.
- B. The client complains of being tired all the time.
- C. The client reports an elevation in his blood pressure.
- D. The client reports discomfort in his legs and back.
Correct Answer: C
Rationale: Erythropoietin can cause hypertension as a side effect, which is significant in CKD patients and warrants notifying the provider. Flu-like symptoms and fatigue are common and expected, while leg/back discomfort is less specific.
If this client shares cultural characteristics of other Native Americans, which findings in the cultural assessment should be included in the client's care plan? Select all that apply.
- A. Native Americans may hesitate to share personal information with strangers.
- B. Questions regarding health history may be interpreted as prying.
- C. Native Americans value listening skills.
- D. Touching on the head is considered offensive.
- E. Native Americans pattern their lifestyle according to 'clock time.'
- F. Direct eye contact should be used when addressing the client or family.
Correct Answer: A,B,C
Rationale: These cultural characteristics reflect common Native American values and should guide culturally sensitive care.
Which intervention should the nurse implement first for the client who has had an incontinent episode?
- A. Palpate the client’s bladder to assess for urinary retention.
- B. Obtain a bedside commode for the client.
- C. Assist the client with changing the wet clothes.
- D. Request the UAP to change the client’s linens.
Correct Answer: C
Rationale: Assisting the client to change wet clothes addresses immediate comfort and dignity, preventing skin breakdown. Palpating the/moist bladder, obtaining a commode, or changing linens are secondary.
The elderly client is diagnosed with chronic glomerulonephritis. Which laboratory value indicates to the nurse the condition has become worse?
- A. The blood urea nitrogen is 15 mg/dL.
- B. The creatinine level is 1.2 mg/dL.
- C. The glomerular filtration rate is 40 mL/min.
- D. The 24-hour creatinine clearance is 100 mL/min.
Correct Answer: C
Rationale: A GFR of 40 mL/min indicates significant renal impairment, suggesting worsening chronic glomerulonephritis. Normal BUN (15 mg/dL), creatinine (1.2 mg/dL), and creatinine clearance (100 mL/min) do not reflect deterioration.