Nokea
Which I.V. medication can the nurse expect the physician to order to treat the client's condition?
- A. Calcium gluconate
- B. Ferrous sulfate
- C. Potassium chloride
- D. Sodium bicarbonate
Correct Answer: A
Rationale: Calcium gluconate is used to treat tetany caused by hypocalcemia in hypoparathyroidism.
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The client develops SIADH secondary to a pituitary tumor. The client's assessment findings include thirst, weight gain, fatigue, and a serum sodium of 127 mEq/L. Which intervention, if prescribed, should the nurse implement to treat SIADH?
- A. Elevate the head of the bed 30 degrees
- B. Administer vasopressin intravenously (IV)
- C. Restrict fluids to 800 to 1000 mL per day
- D. Give 0.3% sodium chloride IV infusion
Correct Answer: C
Rationale: Fluid restriction to 800-1000 mL/day treats mild SIADH with serum sodium >125 mEq/L by raising sodium concentration.
Which arterial blood gas results should the nurse expect in the client diagnosed with diabetic ketoacidosis?
- A. pH 7.34, PaO2 99, PaCO2 48, HCO3 24.
- B. pH 7.38, PaO2 95, PaCO2 40, HCO3 22.
- C. pH 7.46, PaO2 85, PaCO2 30, HCO3 26.
- D. pH 7.30, PaO2 90, PaCO2 30, HCO3 18.
Correct Answer: D
Rationale: DKA causes metabolic acidosis (low pH 7.30, low HCO3 18) with compensatory respiratory alkalosis (low PaCO2 30). Other options show normal or alkalotic states.
The nurse caring for a client diagnosed with cancer of the pancreas writes the problem of 'altered nutrition: less than body requirements.' Which collaborative intervention should the nurse include in the plan of care?
- A. Continuous feedings via (PEG) tube.
- B. Have the family bring in foods from home.
- C. Assess for food preferences.
- D. Refer to the dietitian.
Correct Answer: D
Rationale: Referring to a dietitian ensures specialized nutritional planning for pancreatic cancer, addressing malabsorption and weight loss. PEG feedings, family foods, and preferences are secondary.
The client ate 45 g of carbohydrate (carb) with the dinner meal. The client is to receive 2 units of aspart insulin subcutaneously for each carb choice (CHO) eaten (1 carb choice = 15 g). Which syringe shows the correct amount of insulin that the nurse should administer?
- A. Illustration 1: 16 units
- B. Illustration 2: 29 units
- C. Illustration 3: 1 unit
- D. Illustration 4: 6 units
Correct Answer: D
Rationale: The client should receive 6 units of insulin. Eating 45 g of carbohydrates equals 3 CHOs. If the client is to receive 2 units of insulin for each CHO, the total amount of aspart insulin is 3 CHO times 2 units per CHO = 6 units.
The nurse is preparing to discharge the client following a unilateral adrenalectomy to treat hyperaldosteronism caused by an adenoma. Which instruction should be included in this client's discharge teaching?
- A. Avoid foods high in potassium
- B. Self-monitor blood pressure daily
- C. Stop drugs taken before adrenalectomy
- D. Carry epinephrine for emergency use
Correct Answer: B
Rationale: Self-monitoring BP is necessary as hypertension may persist in 20% of clients post-adrenalectomy.