Nursing Elites

1. A client with chronic renal failure is receiving calcium acetate (PhosLo). The nurse should monitor the client for which of the following side effects?

• A. Hypercalcemia.
• B. Hypocalcemia.
• C. Hyperglycemia.
• D. Hypoglycemia.

Correct answer: A

Rationale: Corrected Question: A client with chronic renal failure is receiving calcium acetate (PhosLo). The nurse should monitor the client for which of the following side effects? Rationale: The correct answer is A, Hypercalcemia. Calcium acetate (PhosLo) is a medication used to lower phosphate levels in patients with chronic renal failure. It works by binding with dietary phosphate and preventing its absorption. However, this can lead to an excess of calcium in the blood, causing hypercalcemia. Therefore, the nurse should closely monitor the client for signs and symptoms of elevated calcium levels, such as nausea, vomiting, confusion, and muscle weakness. Choices B, C, and D are incorrect as calcium acetate does not typically cause hypocalcemia, hyperglycemia, or hypoglycemia.

2. A client is being prepared for transfer to the operating room. Which of the following actions should the nurse take in the care of this client at this time?

• A. Ensuring that the client has voided
• B. Administering all daily medications
• C. Practicing postoperative breathing exercises
• D. Verifying that the client has not eaten for the last 24 hours

Correct answer: A

Rationale: The nurse should ensure that the client has voided, especially if a Foley catheter is not in place. This step is important to prevent urinary retention during the surgical procedure. Administering all daily medications just before surgery is not standard practice. The physician typically provides specific orders regarding which medications can be taken with a sip of water before surgery. Postoperative breathing exercises are usually taught after surgery to prevent complications like atelectasis. Verifying that the client has not eaten for the last 24 hours is not a standard preoperative practice; instead, the client is usually instructed to fast for a specific period before surgery to reduce the risk of aspiration during anesthesia.

3. To reduce the risk of pulmonary complications for a client with ALS, which intervention should the nurse implement?

• A. Perform chest physiotherapy
• B. Teach the client breathing exercises
• C. Initiate passive range of motion exercises
• D. Establish a regular bladder routine

Correct answer: A

Rationale: Performing chest physiotherapy is the most appropriate intervention to reduce the risk of pulmonary complications in clients with ALS. Chest physiotherapy helps mobilize and clear respiratory secretions, improving lung function and reducing the risk of complications such as pneumonia. Teaching breathing exercises (Choice B) may be beneficial for some clients, but chest physiotherapy is more specifically targeted at managing pulmonary issues in ALS. Initiating passive range of motion exercises (Choice C) and establishing a regular bladder routine (Choice D) are important interventions in ALS care but are not directly related to reducing the risk of pulmonary complications.

4. The nurse is preparing to administer the first dose of intravenous ceftriaxone (Rocephin) to a patient. When reviewing the patient’s chart, the nurse notes that the patient previously experienced a rash when taking amoxicillin. What is the nurse’s next action?

• A. Administer the drug and observe closely for hypersensitivity reactions.
• B. Ask the provider whether a cephalosporin from a different generation may be used.
• C. Contact the provider to report drug hypersensitivity.
• D. Notify the provider and suggest an oral cephalosporin.

Correct answer: A

Rationale: When a patient has a history of a rash with amoxicillin, a beta-lactam antibiotic like ceftriaxone should be administered cautiously due to a possible cross-reactivity. The nurse should still administer the drug but closely monitor the patient for any signs of hypersensitivity reactions. Asking for a different generation of cephalosporin or suggesting an oral form does not address the potential cross-reactivity issue. Contacting the provider to report drug hypersensitivity would delay care when the patient needs immediate treatment.

5. Which information about mammograms is most important to provide a post-menopausal female client?

• A. Breast self-examinations are not necessary if annual mammograms are obtained.
• B. Radiation exposure is minimized by shielding the abdomen with a lead-lined apron.
• C. Yearly mammograms should be done regardless of previous normal screenings.
• D. Women at high risk should have annual routine and ultrasound mammograms.

Correct answer: C

Rationale: The most important information to provide a post-menopausal female client regarding mammograms is that yearly mammograms should be done regardless of previous normal screenings. It is crucial for post-menopausal women to continue regular mammograms as they are at a higher risk for breast cancer. Option A is incorrect as breast self-examinations are still recommended in addition to mammograms. Option B is not the most important information compared to the importance of regular mammograms. Option D is not the most important advice for all post-menopausal females but specifically for those at high risk, indicating a more targeted approach.

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