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1. 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 to a patient with chronic kidney disease (CKD) is to reduce phosphate levels. Calcium acetate binds to dietary phosphate, preventing its absorption and helping to manage hyperphosphatemia commonly seen in CKD patients.
2. 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: When a patient is prescribed lisinopril, an ACE inhibitor, the nurse should monitor for hyperkalemia. Lisinopril can cause hyperkalemia by decreasing aldosterone secretion, which leads to potassium retention in the body. Hyperkalemia is a potential side effect of ACE inhibitors and should be closely monitored, as it can have serious consequences such as affecting cardiac function.
3. A client with chronic kidney disease (CKD) is experiencing hyperkalemia. Which intervention should the nurse implement to address this condition?
- A. Administer calcium gluconate.
- B. Encourage a diet high in potassium.
- C. Provide potassium supplements.
- D. Restrict sodium intake.
Correct answer: A
Rationale: Administering calcium gluconate is the appropriate intervention for a client with hyperkalemia. Calcium gluconate helps stabilize the heart by counteracting the effects of high potassium levels and reducing the risk of cardiac complications in individuals with hyperkalemia. Choices B, C, and D are incorrect. Encouraging a diet high in potassium or providing potassium supplements would exacerbate hyperkalemia. Restricting sodium intake is not directly related to addressing hyperkalemia.
4. The mental health nurse observes that a female client with delusional disorder carries some of her belongings with her because she believes that others are trying to steal them. Which nursing action will promote trust?
- A. Explain that distrust is related to feeling anxious.
- B. Initiate short, frequent contacts with the client.
- C. Explain that these beliefs are related to her illness.
- D. Offer to keep the belongings at the nurse's desk.
Correct answer: B
Rationale: Initiating short, frequent contacts with the client is the most appropriate action to promote trust. This approach helps build trust and rapport, addressing the client's need for security. By maintaining regular contact, the nurse can provide reassurance and support, which can help alleviate the client's anxiety related to her delusional beliefs. Choice A does not directly address the client's need for trust and security. Choice C focuses on the client's illness but does not actively address building trust. Choice D, offering to keep the belongings at the nurse's desk, may not be well-received by the client and could potentially worsen her anxiety and distrust.
5. When providing dietary instructions to a client with cirrhosis, which dietary restriction is important for the nurse to emphasize?
- A. Low-protein diet
- B. Low-sodium diet
- C. High-fiber diet
- D. High-calcium diet
Correct answer: B
Rationale: A low-sodium diet is crucial for clients with cirrhosis to manage fluid retention and ascites. Excessive sodium intake can worsen fluid accumulation in the body, leading to complications. By restricting sodium intake, the client can help reduce fluid retention and maintain better overall health. Therefore, emphasizing a low-sodium diet is essential in the dietary management of cirrhosis. Choices A, C, and D are not the primary focus for cirrhosis management. While protein restriction may be necessary in advanced stages of liver disease, it is not the main dietary concern in cirrhosis. High-fiber and high-calcium diets are generally beneficial for overall health but are not specifically emphasized in cirrhosis management.
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