Nursing Elites

1. A client with a history of chronic alcohol abuse is at risk for which of the following conditions?

• A. Liver cirrhosis
• B. Renal failure
• C. Chronic obstructive pulmonary disease (COPD)
• D. Peptic ulcer disease

Correct answer: A

Rationale: Chronic alcohol abuse can lead to liver cirrhosis due to long-term liver damage. Alcohol consumption over time can cause inflammation and scarring of the liver, eventually leading to cirrhosis. This condition can severely impact liver function and may progress to liver failure if not addressed.

2. A client with liver cirrhosis and ascites is being treated with spironolactone. What is a key nursing consideration for this medication?

• A. Monitoring for signs of hyperkalemia
• B. Checking for signs of hypoglycemia
• C. Assessing for signs of dehydration
• D. Observing for symptoms of hyponatremia

Correct answer: A

Rationale: Spironolactone is a potassium-sparing diuretic, which can lead to hyperkalemia as it helps retain potassium in the body. Therefore, monitoring for signs of hyperkalemia such as muscle weakness, arrhythmias, or ECG changes is crucial to prevent potential complications.

3. What side effect should be monitored for in a patient with chronic heart failure taking spironolactone?

• A. Hypokalemia
• B. Hyperkalemia
• C. Hyponatremia
• D. Hypernatremia

Correct answer: B

Rationale: The correct answer is B: Hyperkalemia. Spironolactone is a potassium-sparing diuretic commonly used in patients with heart failure. One of the potential side effects of spironolactone therapy is hyperkalemia, which is an elevated level of potassium in the blood. Hyperkalemia can lead to serious cardiac arrhythmias, making it crucial for healthcare providers to monitor potassium levels closely. Choices A, C, and D are incorrect because hypokalemia (low potassium levels), hyponatremia (low sodium levels), and hypernatremia (high sodium levels) are not typically associated with spironolactone use in patients with chronic heart failure.

4. Why is a low-protein diet recommended for a patient with renal failure?

• A. To prevent fluid overload
• B. To reduce nitrogenous waste
• C. To maintain electrolyte balance
• D. To prevent hyperglycemia

Correct answer: B

Rationale: A low-protein diet is crucial for patients with renal failure to reduce the generation of nitrogenous waste products like urea and creatinine, which the compromised kidneys struggle to eliminate effectively. By limiting protein intake, the production of these waste products is decreased, lessening the burden on the kidneys and helping to manage the progression of renal failure. Choices A, C, and D are incorrect because a low-protein diet primarily aims to reduce the workload on the kidneys by decreasing the production of nitrogenous waste, not to prevent fluid overload, maintain electrolyte balance, or prevent hyperglycemia.

5. A patient with diabetes insipidus is prescribed desmopressin. What is the primary purpose of this medication?

• A. Increase urine output
• B. Reduce blood sugar levels
• C. Decrease urine output
• D. Lower blood pressure

Correct answer: C

Rationale: Desmopressin is prescribed to decrease urine output in patients with diabetes insipidus. It works by increasing water reabsorption in the kidneys, helping to control fluid balance in the body.

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