Nursing Elites

1. The client is planning care for a client who is receiving hemodialysis. Which of the following interventions should be included in the plan of care?

• A. Administer anticoagulants to prevent clot formation.
• B. Monitor the client for signs of infection.
• C. Provide the client with a high-protein diet.
• D. Encourage the client to drink at least 2 liters of fluid daily.

Correct answer: B

Rationale: Monitoring for signs of infection is crucial in clients receiving hemodialysis because they are at an increased risk of infection due to the invasive nature of the procedure. Administering anticoagulants is not typically a part of the routine care for clients undergoing hemodialysis unless specifically prescribed. While a high-protein diet may be beneficial for some clients, it is not a specific intervention related to hemodialysis. Encouraging fluid intake must be individualized based on the client's fluid status and should not be a generalized recommendation for all clients receiving hemodialysis.

2. A young female client prescribed amoxicillin (Amoxil) for a urinary tract infection is being taught by a nurse. Which statement should the nurse include in this client’s teaching?

• A. Use a second form of birth control while taking this medication.
• B. You will experience increased menstrual bleeding while on this medication.
• C. You may experience an irregular heartbeat while on this medication.
• D. Watch for blood in your urine while taking this drug.

Correct answer: A

Rationale: The correct statement for the nurse to include in the teaching is to advise the client to use a second form of birth control while taking amoxicillin. Penicillin, like amoxicillin, may reduce the effectiveness of estrogen-containing contraceptives, making it important to use additional contraceptive measures. The incorrect choices are B, C, and D. Increased menstrual bleeding, irregular heartbeat, or blood in the urine are not common side effects associated with amoxicillin use for a urinary tract infection.

3. After a lumbar puncture, into which position does the nurse assist the client?

• A. Flat
• B. Semi-Fowler
• C. Side-lying with the head of the bed elevated
• D. Sitting up in a recliner with the feet elevated

Correct answer: A

Rationale: After a lumbar puncture, the client should be positioned flat. This position helps prevent post-procedure spinal headaches and cerebrospinal fluid leakage. Keeping the client flat for up to 12 hours is crucial in minimizing these risks. Choices B, C, and D are incorrect because elevating the head of the bed or sitting up can increase the risk of complications by altering the pressure in the spinal canal, potentially leading to headaches and fluid leakage.

4. Which of the following indicates a potential complication of diabetes mellitus?

• A. Inflamed and painful joints.
• B. Blood pressure of 160/100 mm Hg.
• C. Stooped posture.
• D. Hemoglobin of 9 g/dL (90 g/L).

Correct answer: B

Rationale: A blood pressure of 160/100 mm Hg indicates hypertension, which is a common complication of diabetes mellitus due to atherosclerotic changes. Hypertension is a significant risk factor for cardiovascular diseases, which are prevalent in individuals with diabetes. Inflamed and painful joints (Choice A) are not directly related to diabetes complications but may be seen in conditions like arthritis. Stooped posture (Choice C) is more indicative of musculoskeletal issues like osteoporosis, not necessarily a typical complication of diabetes. Hemoglobin level of 9 g/dL (90 g/L) (Choice D) could signify anemia, which can occur in diabetes but is not a primary complication often associated with the disease.

5. The client with diabetes mellitus should be cautioned by the nurse taking a sulfonylurea that alcoholic beverages should be avoided while taking these drugs because they can cause which of the following?

• A. Hypokalemia.
• B. Hyperkalemia.
• C. Hypocalcemia.
• D. Disulfiram (Antabuse)-like symptoms.

Correct answer: D

Rationale: The correct answer is D: Disulfiram (Antabuse)-like symptoms. When a client with diabetes mellitus taking a sulfonylurea consumes alcohol, it can lead to disulfiram-like symptoms, such as nausea, flushing, and palpitations. Choice A, hypokalemia, is incorrect because sulfonylureas do not typically lead to low potassium levels. Choice B, hyperkalemia, is incorrect as sulfonylureas are not associated with high potassium levels. Choice C, hypocalcemia, is also incorrect because sulfonylureas are not known to cause low calcium levels.

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