Nursing Elites

1. A nurse cares for a client with diabetes mellitus who is prescribed metformin (Glucophage) and is scheduled for an intravenous urography. Which action should the nurse take first?

• A. Contact the provider and recommend discontinuing the metformin.
• B. Keep the client NPO for at least 6 hours prior to the examination.
• C. Check the client’s capillary artery blood glucose and administer prescribed insulin.
• D. Administer intravenous fluids to dilute and increase the excretion of dye.

Correct answer: A

Rationale: Metformin can cause lactic acidosis and renal impairment as the result of an interaction with the dye. This drug must be discontinued for 48 hours before the procedure and not started again after the procedure until urine output is well established. The client’s health care provider needs to provide alternative therapy for the client until the metformin can be resumed. Keeping the client NPO, checking the client’s blood glucose, and administering intravenous fluids should be part of the client’s plan of care, but are not the priority, as the examination should not occur while the client is still taking metformin.

2. The healthcare provider is assessing a client with chronic renal failure who is receiving hemodialysis. Which of the following findings would indicate a complication of the treatment?

• A. Temperature of 98.6°F (37°C).
• B. Weight gain of 2 lbs (0.9 kg) since the last treatment.
• C. Blood pressure of 130/80 mm Hg.
• D. Pulse rate of 72 bpm.

Correct answer: B

Rationale: Weight gain between dialysis sessions can indicate fluid overload, a common complication in clients with chronic renal failure. This can lead to complications such as hypertension, pulmonary edema, and heart failure. A normal temperature, blood pressure, and pulse rate are expected findings in this scenario and would not typically indicate a complication of hemodialysis treatment.

3. 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.

4. The client is being educated by the healthcare provider about risk factors associated with atherosclerosis and methods to reduce the risk. Which of the following is a risk factor that the client cannot modify?

• A. Diabetes
• B. Age
• C. Exercise level
• D. Dietary preferences

Correct answer: B

Rationale: Age is a nonmodifiable risk factor for atherosclerosis because it is a natural part of the aging process. While lifestyle factors such as diabetes, exercise level, and dietary preferences can be modified to reduce the risk of atherosclerosis, age cannot be altered. Therefore, age is the correct answer. Diabetes, exercise level, and dietary preferences can all be improved or managed through interventions and lifestyle changes to mitigate the risk of atherosclerosis.

5. A young adult asks the nurse about the normal cholesterol level. The nurse tells the client that the total cholesterol level should be maintained at less than:

• A. 140 mg/dL
• B. 200 mg/dL
• C. 250 mg/dL
• D. 300 mg/dL

Correct answer: B

Rationale: The correct answer is B: 200 mg/dL. A normal cholesterol value ranges between 140 and 199 mg/dL. Total cholesterol levels should ideally be maintained at 200 mg/dL or less to reduce the risk of cardiovascular diseases. Choices A, C, and D are incorrect as they exceed the recommended normal range for total cholesterol levels and may increase the risk of developing heart-related issues.

Similar Questions