Nursing Elites

1. Which of the following clients should refrain from therapy with the thiazide diuretic hydrochlorothiazide?

• A. a client with renal impairment
• B. a client with hypertension
• C. a client with diabetes mellitus, type II
• D. a client with renal calculi (kidney stones)

Correct answer: C

Rationale: The correct answer is a client with diabetes mellitus, type II. Thiazide diuretics like hydrochlorothiazide can cause metabolic abnormalities, including elevated blood glucose levels. This increase is linked to diuretic-induced potassium deficiency, which reduces insulin secretion, leading to higher plasma glucose levels. Thiazides are commonly used in clients with renal impairment and hypertension. Moreover, thiazides decrease calcium excretion, reducing the risk of renal calculi, so it is not contraindicated for clients with kidney stones. Therefore, clients with diabetes mellitus, type II should avoid therapy with hydrochlorothiazide due to the potential adverse effects on blood glucose levels.

2. A client with pancreatitis has been transferred to the intensive care unit. Which order would the nurse anticipate?

• A. Blood pressure monitoring every 15 minutes
• B. Insertion of a Levine tube
• C. Continuous cardiac monitoring
• D. Administration of pain medication every 4 hours

Correct answer: B

Rationale: In a client with pancreatitis who frequently experiences nausea and vomiting, insertion of a Levine tube is often anticipated to decompress the stomach and rest the bowel, helping to alleviate symptoms. This intervention is crucial in managing the gastrointestinal symptoms associated with pancreatitis. Blood pressure monitoring every 15 minutes may be necessary in some cases, but it is not a routine order for pancreatitis, making option A less likely. Continuous cardiac monitoring could be required based on the individual's condition, but it is not typically the first priority in pancreatitis management, so option C is not the most anticipated order. While pain medication administration is essential for managing discomfort, the priority in this scenario, especially considering the symptoms of nausea and vomiting, would be decompression with a Levine tube to address gastrointestinal issues, making option D less likely.

3. A client is admitted with Ewing's sarcoma. Which symptoms would be expected due to this tumor's location?

• A. Hemiplegia
• B. Aphasia
• C. Nausea
• D. Bone pain

Correct answer: D

Rationale: Ewing's sarcoma is a type of bone cancer that primarily affects the bones. Therefore, bone pain would be an expected symptom due to this tumor's location. Hemiplegia, which refers to paralysis on one side of the body, Aphasia, a language disorder, and Nausea are not typical symptoms of Ewing's sarcoma. While Nausea is a common symptom in various conditions, it is not specific to bone cancer like Ewing's sarcoma. Therefore, Bone pain is the most likely symptom associated with Ewing's sarcoma.

4. An infant weighs 7 pounds at birth. What is the expected weight by 1 year of age?

• A. 10 pounds
• B. 12 pounds
• C. 18 pounds
• D. 21 pounds

Correct answer: D

Rationale: A birth weight of 7 pounds typically triples by the age of 1 year, resulting in an expected weight of 21 pounds. This significant weight gain is a normal growth pattern for infants as they usually experience rapid growth in the first year of life. Choices A, B, and C are incorrect because they do not account for the usual growth rate of an infant in the first year. Infants commonly triple their birth weight by the age of 1, making 21 pounds the expected weight.

5. During discharge teaching for a client with diverticulitis on a low-roughage diet, which food should be eliminated from the diet?

• A. Roasted chicken
• B. Noodles
• C. Cooked broccoli
• D. Custard

Correct answer: C

Rationale: The client with diverticulitis needs to avoid gas-forming foods that can increase abdominal discomfort. Cooked broccoli is a high-fiber food that can worsen symptoms. Roasted chicken, noodles, and custard are suitable choices for a low-roughage diet as they are less likely to cause gas formation or abdominal discomfort.

Similar Questions