Nokea
Which of the following diseases or conditions is least likely to be associated with increased potential for bleeding?
- A. metastatic liver cancer
- B. gram-negative septicemia
- C. pernicious anemia
- D. iron-deficiency anemia
Correct Answer: C
Rationale: Pernicious anemia results from vitamin B12 deficiency due to lack of intrinsic factor. This can result from inadequate dietary intake, faulty absorption from the GI tract due to a lack of secretion of intrinsic factor normally produced by gastric mucosal cells and certain disorders of the small intestine that impair absorption. The nurse should instruct the client in the need for lifelong replacement of vitamin B12, as well as the need for folic acid, rest, diet, and support.
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At discharge, the nurse documents that the client taking lithium has an accurate understanding of self-care. On which client statement should the nurse base this judgment?
- A. I need to have my blood lithium level checked every 2 weeks.
- B. I should take my lithium on an empty stomach for best absorption.
- C. I know I need to restrict foods high in sugar while I'm taking lithium.
- D. I need to eat foods containing sodium and drink 2 to 3 liters of fluid daily.
Correct Answer: D
Rationale: The client must consume adequate dietary sodium and 2500 to 3000 mL of fluid per day to prevent dehydration leading to lithium toxicity.
A physician orders a serum creatinine for a hospitalized client. The nurse should explain to the client and his family that this test:
- A. is normal if the level is 4.0 to 5.5 mg/dl.
- B. can be elevated with increased protein intake.
- C. is a better indicator of renal function than the BUN.
- D. reflects the fluid volume status of a person.
Correct Answer: C
Rationale: A serum creatinine level should be 0.7 to 1.5 mg/dl, and it does not vary with increased protein intake, so it is a better indicator of renal function than the BUN, which can be affected by diet and hydration status.
The hospitalized adult is having difficulty falling and staying asleep. The nurse consults standing orders, which have medications included in the table illustrated. Which hypnotic medication should the nurse administer to effectively help the client sleep soundly throughout the night?
- A. Zaleplon
- B. Triazolam
- C. Flurazepam
- D. Eszopiclone
Correct Answer: B
Rationale: Triazolam (Halcion) has a later peak and longer duration, helping the client fall and stay asleep longer.
The client diagnosed with BPD is taking Olanzapine. The nurse evaluates that Olanzapine is effective when observing a reduction in which behaviors? Select all that apply.
- A. Levels of anxiety
- B. The use of splitting
- C. Thoughts of paranoia
- D. Feelings of depression
- E. Expression of hostility
Correct Answer: A,C,E
Rationale: With BPD, reductions in anxiety, paranoia, and hostility indicate olanzapine (Zyprexa) is effective.
The nurse administers risperidone to the client experiencing hallucinations. Which physiological disorder should the nurse assess for considering the risk of developing this disorder as a side effect of risperidone?
- A. Asthma
- B. Hypertension
- C. Crohn's disease
- D. Diabetes mellitus
Correct Answer: D
Rationale: Risperidone (Risperdal) increases the risk of diabetes, especially in the first few months of therapy.