Nursing Elites

1. The patient is receiving sulfadiazine. The healthcare provider knows that this patient’s daily fluid intake should be at least which amount?

• A. 1000 mL/day
• B. 1200 mL/day
• C. 2000 mL/day
• D. 2400 mL/day

Correct answer: C

Rationale: Sulfadiazine may lead to crystalluria, a condition where crystals form in the urine. Adequate fluid intake helps prevent this adverse effect by ensuring urine is dilute enough to prevent crystal formation. The recommended daily fluid intake for a patient receiving sulfadiazine is at least 2000 mL/day. Choices A, B, and D are incorrect because they do not provide a sufficient amount of fluid intake to prevent crystalluria in patients on sulfadiazine.

2. An adult client is admitted with flank pain and is diagnosed with acute pyelonephritis. What is the priority nursing action?

• A. Monitor hemoglobin and hematocrit
• B. Encourage turning and deep breathing
• C. Administer IV antibiotics as prescribed
• D. Auscultate for presence of bowel sounds

Correct answer: C

Rationale: The priority nursing action for a client diagnosed with acute pyelonephritis is to administer IV antibiotics as prescribed. Acute pyelonephritis is a serious kidney infection that requires prompt antibiotic therapy to prevent systemic complications and worsening of the infection. While monitoring hemoglobin and hematocrit (Choice A) is important, it is not the priority in the acute phase of infection. Encouraging turning and deep breathing (Choice B) and auscultating for bowel sounds (Choice D) are relevant aspects of care but do not take precedence over initiating antibiotic treatment to address the infection promptly.

3. To evaluate the positive effect of furosemide (Lasix) 40 mg/day in a client with chronic kidney disease (CKD), what is the best action for the nurse to take?

• A. Obtain daily weights of the client.
• B. Auscultate heart and breath sounds.
• C. Palpate the client’s abdomen.
• D. Assess the client’s diet history.

Correct answer: A

Rationale: The correct answer is A. Furosemide (Lasix) is a loop diuretic used to manage fluid overload and hypertension in clients with CKD. Monitoring daily weights is crucial as weight changes reflect fluid status. Each kilogram of weight change approximately corresponds to 1 liter of fluid retention or loss, making it essential for evaluating the medication's effectiveness. Auscultating heart and breath sounds is more relevant for heart failure cases with fluid retention, not specifically for assessing the effect of furosemide in CKD. Palpating the abdomen is not a direct indicator of furosemide's effectiveness; instead, assessing for edema would be appropriate. While assessing the client's diet history is important to monitor electrolyte balance due to potassium loss with furosemide, it does not directly evaluate the medication's efficacy.

4. In a patient with diabetes mellitus, which of the following is a sign of hypoglycemia?

• A. Polydipsia.
• B. Polyuria.
• C. Sweating.
• D. Dry skin.

Correct answer: C

Rationale: Sweating is a common sign of hypoglycemia in diabetic patients. When blood sugar levels drop too low, the body releases stress hormones like adrenaline, which can cause sweating as a response to the perceived danger. Polydipsia (excessive thirst) and polyuria (excessive urination) are actually more commonly associated with hyperglycemia, not hypoglycemia. Dry skin is not typically a sign of hypoglycemia.

5. A client with chronic renal failure is receiving calcium acetate (PhosLo). The nurse should monitor the client for which of the following side effects?

• A. Hypercalcemia.
• B. Hypocalcemia.
• C. Hyperglycemia.
• D. Hypoglycemia.

Correct answer: A

Rationale: Corrected Question: A client with chronic renal failure is receiving calcium acetate (PhosLo). The nurse should monitor the client for which of the following side effects? Rationale: The correct answer is A, Hypercalcemia. Calcium acetate (PhosLo) is a medication used to lower phosphate levels in patients with chronic renal failure. It works by binding with dietary phosphate and preventing its absorption. However, this can lead to an excess of calcium in the blood, causing hypercalcemia. Therefore, the nurse should closely monitor the client for signs and symptoms of elevated calcium levels, such as nausea, vomiting, confusion, and muscle weakness. Choices B, C, and D are incorrect as calcium acetate does not typically cause hypocalcemia, hyperglycemia, or hypoglycemia.

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