Nokea
Which of the following is a sign of hypocalcemia?
- A. Hyperactive reflexes.
- B. Depressed reflexes.
- C. Muscle cramps.
- D. Seizures.
Correct Answer: A
Rationale: Hyperactive reflexes are a classic sign of hypocalcemia. Hypocalcemia leads to increased neuromuscular excitability, resulting in hyperactive reflexes. Depressed reflexes (Choice B) are not typically associated with hypocalcemia. Muscle cramps (Choice C) can be seen in hypocalcemia due to muscle irritability but are not a specific sign. Seizures (Choice D) can occur in severe cases of hypocalcemia but are not as common as hyperactive reflexes.
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In a client with heart failure presenting bilateral +4 edema of the right ankle extending up to midcalf while sitting with legs dependent, what is the priority goal?
- A. Decrease venous congestion.
- B. Maintain normal respirations.
- C. Maintain body temperature.
- D. Prevent injury to lower extremities.
Correct Answer: A
Rationale: The priority goal in this scenario is to decrease venous congestion. By elevating the legs above the heart level, venous return is improved, reducing congestion in the lower extremities. This intervention helps decrease swelling and prevents complications such as impaired tissue perfusion. Maintaining normal respirations and body temperature are important aspects of care but are secondary to addressing the immediate issue of venous congestion. Preventing injury to lower extremities is also essential but takes precedence after managing the venous congestion to prevent further complications.
A client receiving warfarin (Coumadin) therapy should have which of the following laboratory results reviewed to evaluate the effectiveness of the therapy?
- A. Complete blood count (CBC).
- B. Prothrombin time (PT).
- C. International normalized ratio (INR).
- D. Partial thromboplastin time (PTT).
Correct Answer: C
Rationale: The correct answer is C: International normalized ratio (INR). The INR is the most appropriate laboratory result to review when evaluating the effectiveness of warfarin (Coumadin) therapy. Warfarin is an anticoagulant medication, and the INR helps determine if the dosage is within a therapeutic range to prevent clotting or bleeding complications. Choice A, a Complete Blood Count (CBC), provides information about the cellular components of blood but does not directly assess the anticoagulant effects of warfarin. Choice B, Prothrombin time (PT), measures the time it takes for blood to clot but is not as specific for monitoring warfarin therapy as the INR. Choice D, Partial Thromboplastin Time (PTT), evaluates the intrinsic pathway of coagulation and is not the primary test used to monitor warfarin therapy.
The healthcare provider assesses a client with cirrhosis and finds 4+ pitting edema of the feet and legs, and massive ascites. Which mechanism contributes to edema and ascites in clients with cirrhosis?
- A. Hyperaldosteronism causing increased sodium transport ion in renal tubules
- B. Decreased portacaval pressure with greater collateral circulation
- C. Decreased renin-angiotensin response related to increased renal blood flow
- D. Hypoalbuminemia that results in decreased colloidal oncotic pressure
Correct Answer: D
Rationale: In clients with cirrhosis, hypoalbuminemia leads to decreased colloidal oncotic pressure. This reduction in oncotic pressure contributes to the development of edema in the feet and legs (pitting edema) and ascites in the abdomen. Hyperaldosteronism (choice A) would lead to sodium retention but is not the primary mechanism behind edema and ascites in cirrhosis. Decreased portacaval pressure with greater collateral circulation (choice B) is not directly related to the pathophysiology of edema and ascites in cirrhosis. Decreased renin-angiotensin response related to increased renal blood flow (choice C) does not play a significant role in the development of edema and ascites in cirrhosis compared to the impact of hypoalbuminemia on colloidal oncotic pressure.
A male client expresses concern about how a hypophysectomy will affect his sexual function. Which of the following statements provides the most accurate information about the physiologic effects of hypophysectomy?
- A. Removing the source of excess hormone should restore the client's libido, erectile function, and fertility.
- B. Potency will be restored, but the client will remain infertile.
- C. Fertility will be restored, but impotence and decreased libido will persist.
- D. Exogenous hormones will be needed to restore erectile function after the adenoma is removed.
Correct Answer: A
Rationale: Choice A is the most accurate statement regarding the physiologic effects of hypophysectomy on sexual function. The client's sexual problems are directly related to excessive hormone levels. Removing the source of excess hormone secretion through hypophysectomy should allow the client to return to a normal physiologic pattern, which includes restoring libido, erectile function, and fertility. Choices B, C, and D are incorrect. Choice B incorrectly states that the client will remain infertile, which is not necessarily true after a hypophysectomy. Choice C inaccurately suggests that fertility will be restored while impotence and decreased libido will persist, which is not aligned with the expected outcomes of hypophysectomy. Choice D is incorrect because exogenous hormones are typically not needed to restore erectile function after the adenoma is removed; rather, the removal of the source of excessive hormone secretion should address the sexual function concerns.
A client with chronic renal failure is receiving epoetin alfa (Epogen). The nurse should assess the client for which of the following complications?
- A. Hypertension.
- B. Hypotension.
- C. Hyperglycemia.
- D. Edema.
Correct Answer: A
Rationale: The correct answer is A: Hypertension. Epoetin alfa (Epogen) is known to increase blood pressure by stimulating red blood cell production. Monitoring for hypertension is crucial to prevent complications such as heart failure or stroke. Choices B, C, and D are incorrect because hypotension, hyperglycemia, and edema are not typically associated with epoetin alfa therapy in clients with chronic renal failure.