Nursing Elites

1. A client is receiving continuous ambulatory peritoneal dialysis. Which of the following statements indicates the need for more teaching by the nurse?

• A. I should take all my medications every morning.
• B. The catheter should always remain in place.
• C. The catheter should be flushed daily with sterile saline.
• D. If I gain 2 pounds, I should skip dialysis that day.

Correct answer: D

Rationale: The correct answer is D. Gaining weight is a sign that the client may be retaining fluid, indicating a need for dialysis to remove excess fluid. Skipping dialysis based on weight gain can lead to fluid overload, electrolyte imbalances, and other serious complications. Choices A, B, and C are all correct statements regarding peritoneal dialysis care: taking medications as prescribed is essential for overall health, ensuring the catheter remains in place is crucial to prevent infection, and flushing the catheter with sterile saline daily helps maintain its patency and reduce the risk of infections.

2. A client with chronic renal failure is receiving epoetin alfa (Epogen). The nurse should assess the client for which of the following complications?

• A. Hypertension.
• B. Hypotension.
• C. Hyperglycemia.
• D. Edema.

Correct answer: A

Rationale: The correct answer is A: Hypertension. Epoetin alfa (Epogen) is known to increase blood pressure by stimulating red blood cell production. Monitoring for hypertension is crucial to prevent complications such as heart failure or stroke. Choices B, C, and D are incorrect because hypotension, hyperglycemia, and edema are not typically associated with epoetin alfa therapy in clients with chronic renal failure.

3. What is an expected outcome when a client is receiving an IV administration of furosemide?

• A. Increased blood pressure.
• B. Increased urine output.
• C. Decreased pain.
• D. Decreased premature ventricular contractions.

Correct answer: B

Rationale: The correct answer is B: Increased urine output. Furosemide is a loop diuretic that works by inhibiting the reabsorption of sodium and chloride in the ascending loop of Henle in the kidneys, leading to increased urine production. This diuretic effect helps to reduce fluid volume in the body, making it an expected outcome when a client is receiving furosemide. Choice A, increased blood pressure, is incorrect because furosemide typically causes a decrease in blood pressure due to its diuretic effect. Choice C, decreased pain, and choice D, decreased premature ventricular contractions, are unrelated to the pharmacological action of furosemide.

4. Which of the following conditions is most commonly associated with a high risk of stroke?

• A. Hypertension.
• B. Diabetes.
• C. Obesity.
• D. Smoking.

Correct answer: A

Rationale: Hypertension is the correct answer. Hypertension, also known as high blood pressure, is a major risk factor for stroke because it puts increased pressure on blood vessels in the brain, making them more prone to damage and increasing the likelihood of a stroke. While diabetes, obesity, and smoking are also risk factors for stroke, hypertension is the most commonly associated condition with a high risk of stroke due to its direct impact on the blood vessels.

5. 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.

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