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Which signs or symptoms are characteristic of an adult client diagnosed with Cushing's syndrome?
- A. Husky voice and complaints of hoarseness.
- B. Warm, soft, moist, salmon-colored skin.
- C. Visible swelling of the neck, with no pain.
- D. Central-type obesity, with thin extremities.
Correct Answer: D
Rationale: The correct answer is D because central-type obesity with thin extremities is a classic characteristic of Cushing's syndrome due to excess cortisol. This pattern of weight distribution is caused by cortisol's impact on fat metabolism and distribution. A is incorrect because a husky voice and hoarseness are not typical symptoms of Cushing's syndrome. B is incorrect as warm, soft, moist, salmon-colored skin is not a common finding in Cushing's syndrome. C is incorrect because visible swelling of the neck without pain is not a typical sign of Cushing's syndrome.
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A patient with chronic kidney disease (CKD) is prescribed calcium acetate. What is the primary purpose of this medication?
- A. Treat hyperkalemia
- B. Reduce phosphate levels
- C. Lower blood pressure
- D. Increase hemoglobin levels
Correct Answer: B
Rationale: The primary purpose of prescribing calcium acetate for a patient with CKD is to reduce phosphate levels. Calcium acetate acts as a phosphate binder, preventing the absorption of dietary phosphate in the intestines. Elevated phosphate levels in CKD can lead to complications such as mineral and bone disorders. Treating hyperkalemia (A) involves other medications like potassium binders, not calcium acetate. Lowering blood pressure (C) typically involves antihypertensive drugs. Increasing hemoglobin levels (D) is usually managed with erythropoiesis-stimulating agents in CKD patients. Therefore, option B is the correct answer for the primary purpose of prescribing calcium acetate in CKD patients.
A patient with hypertension is prescribed lisinopril. What side effect should the nurse monitor for?
- A. Hyperkalemia
- B. Hypoglycemia
- C. Bradycardia
- D. Constipation
Correct Answer: A
Rationale: The correct answer is A: Hyperkalemia. Lisinopril is an ACE inhibitor that can cause potassium retention, leading to hyperkalemia. Monitoring potassium levels is crucial to prevent serious complications like cardiac arrhythmias. Hypoglycemia (B) is not a common side effect of lisinopril. Bradycardia (C) and constipation (D) are also not typically associated with lisinopril use. Hyperkalemia is the most critical side effect to monitor in this case.
A patient with rheumatoid arthritis is taking prednisone. What is an important side effect for the nurse to monitor?
- A. Hyperglycemia
- B. Bradycardia
- C. Hypotension
- D. Hyperkalemia
Correct Answer: A
Rationale: The correct answer is A: Hyperglycemia. Prednisone is a corticosteroid that can cause an increase in blood glucose levels by promoting gluconeogenesis and decreasing insulin sensitivity. Monitoring for hyperglycemia is crucial as it can lead to serious complications such as diabetic ketoacidosis. Bradycardia (B) and hypotension (C) are not typical side effects of prednisone, as it tends to cause fluid retention and hypertension. Hyperkalemia (D) is also unlikely as prednisone can actually cause hypokalemia due to increased renal potassium excretion.
Following a CVA, the nurse assesses that a client has developed dysphagia, hypoactive bowel sounds, and a firm, distended abdomen. Which prescription for the client should the nurse question?
- A. Continuous tube feeding at 65 ml/hr via gastrostomy.
- B. Total parenteral nutrition to be infused at 125 ml/hour.
- C. Nasogastric tube connected to low intermittent suction.
- D. Metoclopramide (Reglan) intermittent piggyback.
Correct Answer: A
Rationale: The correct answer is A: Continuous tube feeding at 65 ml/hr via gastrostomy. After a CVA, dysphagia, hypoactive bowel sounds, and a firm, distended abdomen indicate a risk for aspiration and bowel obstruction. Continuous tube feeding may worsen these issues. Option B provides nutrition intravenously, bypassing the gastrointestinal tract. Option C helps decompress the stomach. Option D is a medication to help with GI motility. Therefore, the nurse should question option A due to the risk of complications post-CVA.
The charge nurse observes that a client with a nasogastric tube on low intermittent suction is drinking a glass of water immediately after the unlicensed assistive personnel (UAP) left the room. What action should the nurse take?
- A. Remove the glass of water and speak to the UAP.
- B. Discuss the incident with the UAP at the end of the day.
- C. Write an incident report and notify the healthcare provider.
- D. Remind the client of the potential for electrolyte imbalance.
Correct Answer: A
Rationale: The correct answer is A: Remove the glass of water and speak to the UAP. The rationale is as follows: 1) Drinking water with low intermittent suction can cause complications. 2) Immediate action is necessary to prevent harm. 3) Speaking to the UAP clarifies the situation and provides education. 4) Removing the glass of water ensures the client's safety.
Incorrect choices:
B: Discussing at the end of the day delays action and puts the client at risk.
C: Writing an incident report is important, but immediate intervention is needed first.
D: Reminding the client of electrolyte imbalance does not address the current issue of drinking water with a nasogastric tube.