Nokea
Which information is a priority for the nurse to reinforce to an older client after intravenous pyelography?
- A. Eat a light diet for the rest of the day
- B. Rest for the next 24 hours since the preparation and the test is tiring
- C. During waking hours drink at least 1 8-ounce glass of fluid every hour for the next 2 days
- D. Measure the urine output for the next day and immediately notify the health care provider if it should decrease
Correct Answer: D
Rationale: This information would alert to the complication of acute renal failure which may occur as a complication from the dye and the procedure. Renal failure occurs most often in elderly patients who are chronically dehydrated before the dye injection.
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A client diagnosed with cirrhosis of the liver and ascites is receiving spironolactone (Aldactone). The nurse understands that this medication spares elimination of which element?
- A. Sodium
- B. Potassium
- C. Phosphate
- D. Albumin
Correct Answer: B
Rationale: Potassium. If ascites is present in the client with cirrhosis of the liver, potassium-sparing diuretics such as Aldactone should be administered because it inhibits the action of aldosterone on the kidneys.
The nurse is performing a physical assessment on a client who just had an endotracheal tube (ET) inserted. Which finding would call for immediate action by the nurse?
- A. Breath sounds can be heard bilaterally
- B. Mist is visible in the T-Piece
- C. Pulse oximetry of 88 BPM
- D. Client is unable to speak
Correct Answer: C
Rationale: Pulse oximetry of 88 BPM. Pulse oximetry should not be lower than 90. Placement of the ET will need to be checked, along with the ventilator settings.
The nurse is preparing to care for the client with Ebola, a febrile, hemorrhagic disease. After selecting a disposable surgical hood that extends to the shoulders, what additional PPE should the nurse obtain? Select all that apply.
- A. Docimeter
- B. Disposable N95 respirator
- C. Disposable full face shield
- D. Cloth gown that cannot be reused
- E. Two pair nitrile examination gloves
- F. Boot covers extending to mid-calf
Correct Answer: B,C,E,F
Rationale: B: N95 respirator protects against possible airborne transmission. C: Face shield prevents mucosal exposure. E: Double gloves enhance protection. F: Boot covers prevent lower leg exposure. A: Docimeters are for radiation. D: Cloth gowns are inadequate; impermeable gowns are needed.
A college student is hospitalized with meningococcal meningitis after being seen in the campus clinic. What is the nurse's responsibility to the campus community regarding this diagnosis?
- A. Quarantine all students and faculty remaining on the campus
- B. E-mail school administrators with the names of infected students
- C. Identify all individuals who have had close contact with the student
- D. Ensure that everyone on campus receive prophylactic antibiotics
Correct Answer: C
Rationale: C: Identifying close contacts allows targeted prophylaxis, preventing spread. A: Quarantine is excessive. B: Sharing names violates privacy. D: Prophylaxis is only for close contacts.
Following morning shift report the nurse plans to assess clients who had surgery two days ago. Which client should the nurse assess first?
- A. 30-year-old who had a splenectomy and has an oral temperature of 102.2°F (39°C)
- B. 69-year-old who had a right total hip arthroplasty and has a WBC count of 12,100/mm3
- C. 55-year-old who had a lumbar discectomy and was given 30 mg oral oxycodone at 0700
- D. 40-year-old with external traction for a tibia fracture and has a platelet count of 100 K/mm3
Correct Answer: A
Rationale: A: High fever post-splenectomy suggests possible sepsis, requiring immediate assessment. B: Slightly elevated WBC is expected. C, D: Pain management and low platelets are less urgent.