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A nurse is reviewing the medical record of a client who has acute gout. The nurse should expect an increase in which of the following laboratory results?
- A. Intrinsic factor
- B. Uric acid
- C. Chloride level
- D. Creatinine kinase
Correct Answer: B
Rationale: The correct answer is B: Uric acid. In acute gout, there is an accumulation of uric acid crystals in the joints, leading to inflammation and pain. As a result, the uric acid levels in the blood increase. Monitoring uric acid levels helps in diagnosing and managing gout.
Explanation for other choices:
A: Intrinsic factor - Intrinsic factor is related to vitamin B12 absorption, not gout.
C: Chloride level - Chloride level is not directly impacted by acute gout.
D: Creatinine kinase - Creatinine kinase is an enzyme related to muscle breakdown, not specifically affected by gout.
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A nurse is caring for a client who is experiencing an exacerbation of heart failure. Thenurse is
assessing the client 24 hr later. How should the nurse interpret the findings related to the
diagnosis of heart failure? For each finding, click to specify whe ther the finding is unrelated to
the diagnosis, a sign of potential improvement, or a sign of potential worsening condition. Diagnostic Results
Hgb 8.4 g/dL (12 to 18 g/dL)
Hct 42% (37% to 47%)
WBC count 9,800/mm3 (5,000 to 10,000/ mm3) Potassium 432
mEq/L (3.5 to 5 mEq/L)
- A. Lung sounds clean
- B. Creatinine 1.8 mm/dl
- C. Weight 113kg(249 lb)
- D. WBC Count 11,800mm3
- E. Temperature: 38.5°C (101.3°F)
- F. Shortness of breath with exertion
Correct Answer: A, B,C,D,E
Rationale:
The correct answer is A, B, C, D, E. In heart failure exacerbation, key indicators are related to fluid overload and organ perfusion. A) Lung sounds clean indicate potential improvement in pulmonary congestion. B) Creatinine 1.8 mm/dl is important for kidney function monitoring, as worsening kidney function can occur in heart failure. C) Weight 113kg reflects fluid retention, relevant for heart failure management. D) WBC count (11,800mm3) can indicate infection, which can worsen heart failure. E) Temperature 38.5°C can suggest infection or systemic inflammatory response, which worsens heart failure.
A nurse is preparing to administer propranolol to several clients. For which of the following clients should the nurse clarify the prescription with the provider before administration?
- A. A client who has a history of asthma
- B. A client who has hypertension
- C. A client who has a history of migraines
- D. A client who has stable angina
Correct Answer: A
Rationale: The correct answer is A: A client who has a history of asthma. Propranolol is a non-selective beta-blocker that can potentially cause bronchoconstriction in clients with asthma due to its beta-2 antagonistic effects. The nurse should clarify the prescription with the provider for this client to avoid exacerbating respiratory issues. Choices B, C, and D are not contraindications for propranolol administration, as hypertension, migraines, and stable angina are conditions that can be treated with beta-blockers. It is important for the nurse to assess each client's medical history and consider potential contraindications before administering medications to ensure client safety and optimal outcomes.
A nurse is caring for a client who has acute heart failure and received morphine IV 30 min ago. Which of the following findings should the nurse identify as an indication that the medication was effective?
- A. Decreased anxiety
- B. Emesis of 250 mL
- C. Increased respiratory rate to 26/min
- D. Decreased urinary output
Correct Answer: A
Rationale: The correct answer is A: Decreased anxiety. Morphine is often used to relieve pain and anxiety in patients with acute heart failure. The nurse should expect a reduction in anxiety as a positive response to the medication. Emesis (choice B) is not a typical indication of morphine effectiveness. Increased respiratory rate (choice C) may indicate respiratory depression, a potential adverse effect of morphine. Decreased urinary output (choice D) could suggest decreased cardiac output, which is not necessarily a sign of morphine effectiveness in this case.
A nurse is providing teaching for a client who has diabetes mellitus about the self-administration of insulin.The client has prescriptions for regular and NPH insulins. Which
of the following statements by the client indicates an understanding of the teaching?
- A. I will draw up the regular insulin into the syringe first.
- B. I will shake the NPH vial vigorously before drawing up the insulin.
- C. I will store prefilled syringes in the refrigerator with the needle pointed downward.
- D. I will insert the needle at a 15-degree angle.
Correct Answer: A
Rationale: Correct Answer: A: I will draw up the regular insulin into the syringe first.
Rationale: Drawing up regular insulin first is crucial for preventing contamination between the two insulins. Regular insulin is a clear solution and should be drawn up first to prevent any cloudiness or contamination from the NPH insulin, which is a cloudy suspension. Drawing up regular insulin first ensures accuracy in dosing and prevents mixing of the two insulins.
Incorrect Choices:
B: Shaking the NPH vial vigorously before drawing up the insulin is incorrect as it can cause bubbles and affect the accuracy of the dose.
C: Storing prefilled syringes in the refrigerator with the needle pointed downward is incorrect as it can lead to leakage or contamination.
D: Inserting the needle at a 15-degree angle is incorrect as insulin injections should be administered at a 90-degree angle for proper absorption.
A nurse is assessing a client who recently had a myocardial infarction. Which of the following findings indicates that the client might be developing pulmonary edema?
- A. Excessive somnolence
- B. Epistaxis
- C. Pink
- D. frothy sputum
- E. Tachypnea
Correct Answer: C
Rationale: The correct answer is C: Pink frothy sputum. This finding indicates pulmonary edema, which is characterized by fluid accumulation in the lungs. The pink color indicates the presence of blood in the sputum, a common sign of pulmonary edema. Excessive somnolence (A) is more indicative of respiratory depression or hypoxia, while epistaxis (B) is associated with hypertension or nasal trauma. Tachypnea (E) can be a sign of respiratory distress but does not specifically indicate pulmonary edema.