Nokea
Which of the following is the most common initial manifestation of acute renal failure?
- A. Dysuria.
- B. Anuria.
- C. Hematuria.
- D. Oliguria.
Correct Answer: D
Rationale: Oliguria, reduced urine output, is the most common initial sign of acute renal failure due to impaired kidney filtration.
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The nurse is teaching a client about newly prescribed isoniazid (INH) for pulmonary tuberculosis. Which of the following statements by the client would require follow up?
- A. I will have to take this medication for three months.
- B. I will need to have my blood drawn periodically to see if I am having an adverse effect to this medication.
- C. I will not be considered infectious if I have three consecutive negative sputum samples.
- D. This medication may make my hands and feet have numbness and tingling sensations.
Correct Answer: A
Rationale: Choice A requires follow-up because isoniazid (INH) treatment for pulmonary tuberculosis typically lasts 6-9 months, not 3 months. Choice B is correct; periodic blood tests monitor for hepatotoxicity. Choice C is correct; three consecutive negative sputum samples indicate non-infectiousness. Choice D is correct; INH can cause peripheral neuropathy, manifesting as numbness and tingling.
Which of the following goals is a priority for a client who has undergone surgery for retinal detachment?
- A. Control pain.
- B. Prevent an increase in intraocular pressure.
- C. Follow a low-sodium diet.
- D. Maintain a darkened environment.
Correct Answer: B
Rationale: Preventing an increase in intraocular pressure is the priority to protect the surgical repair and prevent complications like re-detachment or hemorrhage.
The nurse is administering packed red blood cells (PRBCs) to a client. The nurse should first:
- A. Discontinue the I.V. catheter if a blood transfusion reaction occurs.
- B. Administer the PRBCs through a percutaneously inserted central catheter line with a 20-gauge needle.
- C. Flush PRBCs with 5% dextrose and 0.45% normal saline solution.
- D. Stay with the client during the first 15 minutes of infusion.
Correct Answer: D
Rationale: The nurse should stay with the client during the first 15 minutes of a blood transfusion, as this is the most likely time for a transfusion reaction to occur. Close monitoring allows for immediate intervention if a reaction is detected. Discontinuing the IV is only done if a reaction occurs, PRBCs should not be administered via a 20-gauge needle (a larger gauge is needed), and dextrose solutions are incompatible with PRBCs.
Which of the following is a priority nursing diagnosis for the diabetic client who is taking insulin and has nausea and vomiting from a viral illness or influenza?
- A. Imbalanced nutrition: Less than body requirements.
- B. Ineffective health maintenance related to ineffective coping skills.
- C. Acute pain.
- D. Activity intolerance.
Correct Answer: A
Rationale: Nausea and vomiting from illness can lead to inadequate food intake, causing imbalanced nutrition, a priority due to the risk of hypoglycemia or ketoacidosis.
A client who has undergone a mastectomy is worried about her body image and its impact on her sexual relationship. The nurse should suggest:
- A. Wearing a prosthesis during intimate moments.
- B. Avoiding discussions about her surgery with her partner.
- C. Focusing only on non-physical aspects of intimacy.
- D. Ignoring her concerns as they are temporary.
Correct Answer: A
Rationale: Wearing a prosthesis can help the client feel more confident about her body image during intimate moments, supporting her sexual relationship.