PATIENT EDUCATION, HEALTH PROMO, LAB VALUES PRACTICE Q's

A nurse is teaching a client who has chronic kidney failure about planning a low-protein diet. The client states, "Why do I have to be concerned about protein?" Which of the following responses should the nurse make?

"A low-protein diet reduces the risk for uremia." (Urea is a waste product of protein breakdown and can accumulate in clients who have kidney failure, causing uremia.)

A nurse is teaching a middle-age client about HTN. Which of the following information should the nurse include in the teaching?

"Diuretics are the first type of medication to control hypertension."

A nurse is reviewing the laboratory results for a client who has a history of atherosclerosis and notes elevated cholesterol levels. Which of the following statements by the client indicates the nurse should plan follow-up teaching on a low-cholesterol diet?

"I eat two eggs for breakfast each morning."

A nurse is providing teaching about a heart healthy diet to a group of client with HTN. Which of the following statements by one of the clients indicates a need for further teaching?

"I may eat 10 ounces of lean protein each day."

A nurse is providing discharge instructions for a client who has CHF. Which of the following client statements indicates to the nurse that the teaching was effective?

"I plan to slow down if I am tired the day after exercising."

A nurse is instructing a young adult client about healthful sleep habits. Which of the following statements should the nurse identify as an indication that the client needs further teaching?

"I watch television until I fall asleep"

A nurse is conducting a health promotion class for clients and their children about sun protection. The nurse should identify which of the following client responses as an indication that the teaching was effective?

"I will avoid sitting in the sun between 10 a.m. and 3 p.m

A nurse in a clinic teaching a group of clients about preventing low back pain and injury. Which of the following statements should the nurse identify as an indication that the client requires further clarification?

"I'll sit with my knees lower than my hips"

A nurse is preparing to collect health history data during a client's admission. Which of the following questions should the nurse use to promote

"What brought you to the hospital?"

A nurse is caring for a client who has HTN and is afraid to take his blood pressure medication. Which of the following nursing statements is an example of the therapeutic communication response of reflection?

"You seem upset about taking your blood pressure medication."

A nurse is teaching a client who has constipation. Which of the following should the nurse discuss as causes of constipation? (SATA)

- Excessive laxative use - Ignoring the urge to defecate - Inadequate fluid intake

A nurse is teaching a class of older adults about the expected physiologic changes of aging. Which of the following changes should the nurse include in the discussion? (SATA)

- More difficulty seeing due to a greater sensitivity to glare - Decrease cough reflex -Decreased bladder capacity -Dehydration of intervertebral discs

A nurse is providing teaching about a heart healthy diet to a group of clients with hypertension. Which of the following statements by one of the clients indicates a need for further teaching? -"I may eat 10 ounces of lean protein each day." -"Fresh fruits make a good snack option." -"I will replace table salt with dried herbs." -"I may thicken gravies with cornstarch as I cook."

-"I may eat 10 ounces of lean protein each day." (Lean meats should be limited to 5 to 6 oz per day.) !!! -"Fresh fruits make a good snack option." -"I will replace table salt with dried herbs." (Salt should be replaced with dried or fresh herbs.) -"I may thicken gravies with cornstarch as I cook."

A nurse is reinforcing teaching with a client regarding reduction of risk factors for coronary artery disease. Which of the following statements by the client indicates an understanding of the teaching? (Select all that apply) -"I must stop smoking." -"I should limit my exercise." -"I will stop consuming alcohol." -"I need to monitor my weight." -"I am limiting my intake of fast foods."

-"I must stop smoking." (Nicotine in tobacco causes peripheral vasoconstriction, which increases BP, cardiac afterload, and oxygen consumption. Alterations in blood vessels contribute to atherosclerosis and the formation of clots. Smoking cessations can decrease the risk of coronary artery disease by as much as 80%. Clients also should avoid secondhand smoke.) !!! -"I should limit my exercise." (A sedentary lifestyle or lack of exercise can lead to obesity, which is a significant contributing factor to the development of hypertension and heart disease. Less active individuals have a 30-50% increased incidence of developing hypertension. Regular physical activity helps to maintain body weight, decrease the risk of hypertension, and optimize lipid levels. Physical activity and dietary modification have been positively associated with decreased lipid and cholesterol levels.) -"I will stop consuming alcohol." (The client does not have to stop consuming alcohol. Consuming less than 3 oz per day can assist in decreasing the risk of coronary artery disease. However, consuming more than 3 oz per day has been associated with an increased risk of cardiac disease.) -"I need to monitor my weight." (Obesity or an increase in weight is a significant factor in developing coronary artery disease. Weight management is vital to decreasing the risk of coronary artery disease.) !!! -"I am limiting my intake of fast foods." (Fast foods typically are prepared with high sodium and high fat, which increase the risk of atherosclerosis and coronary artery disease. An elevated cholesterol and serum lipid level predisposes a client to coronary artery disease. To promote cardiovascular health, clients should select healthier food options, such as fruits and vegetables, or foods prepared by baking or broiling.) !!!

A nurse is teaching a group of older adults about health tests and screenings. Which of the following information should the nurse include? (SATA)

-"You should have a single dose of the shingles vaccine at age 60" -"You should have a the pneumococcal vaccine at age 65 and then every 10" -"You should have visual acuity screening every year"

A nurse is collecting a medication history from a client who is scheduled to have a cardiac catheterization. Which of the following medications taken by the client interacts with contrast material and places the client at risk for acute kidney injury? -Atorvastatin -Metformin -Nitroglycerin -Carvedilol

-Atorvastatin (This is contraindicated for a client who has active hepatic disease, but it does not interact with contrast material) -Metformin (This interacts with contrast dye and can cause acute kidney damage.) !!! -Nitroglycerin (This is contraindicated for a number of conditions including increased intracranial pressure, but it does not interact with contrast material). -Carvedilol (This is contraindicated for a number of conditions including 2nd and 3rd degree heart block, but it does not interact with contrast material.)

A nurse is caring for a client who is taking lisinopril. Which of the following outcomes indicates a therapeutic effect of the medication? -Decreased blood pressure -Increase of HDL cholesterol -Prevention of bipolar manic episodes -Improved sexual function

-Decreased blood pressure (Lisinopril, an ACE inhibitor, may be used alone or in combination with other antihypertensives in the management of hypertension and congestive heart failure. A therapeutic effect of the medication is a decrease in BP.) !!! -Increase of HDL cholesterol (This is not an intended effect of lisinopril.) -Prevention of bipolar manic episodes (This is not an intended effect of lisinopril.) -Improved sexual function (This is not an intended effect of lisinopril. Lisinopril may in fact cause sexual dysfunction and impotence.)

A nurse is teaching a client who has a history of ulcerative colitis and a new diagnosis of anemia. Which of the following manifestations of colitis should the nurse identify as a contributing factor to the development of the anemia? -Dietary iron restrictions -Intestinal malabsorption syndrome -Chronic blood loss -Intestinal parasites

-Dietary iron restrictions (Dietary approaches to ulcerative colitis do not restrict iron; in fact, they often include supplemental iron in an attempt to prevent anemia.) -Intestinal malabsorption syndrome (Ulcerative colitis is an inflammatory bowel disease affecting primarily the sigmoid colon and rectum, although the entire colon may be affected. A malabsorption syndrome is more likely to be caused by a condition affecting the small intestine.) -Chronic blood loss (A client with long-standing ulcerative colitis is most likely anemic due to chronic blood loss in small amounts that occurs over time, although the colitis may result in erosion of the intestine and hemorrhage. These clients often report bloody stools and are therefore at increased risk for developing anemia.) !!! -Intestinal parasites (This is not a manifestation of ulcerative colitis. This inflammatory bowel disease can cause dehydration, fever, weight loss and anorexia.)

A nurse is preparing to administer a transfusion of RBCs to a client who has heart failure. For which of the following manifestations should the nurse monitor to prevent fluid volume overload? (Select all that apply.) -Dyspnea -Gastrointestinal bloating -Jugular vein distention -Confusion -Hypotension

-Dyspnea !!! -Gastrointestinal bloating -Jugular vein distention !!! -Confusion !!! -Hypotension (Actually hypertension. Hypotension is a manifestation of a hemolytic transfusion reaction.)

A nurse is assessing a client who is postoperative and has anemia due to excess blood loss following surgery. Which of the following findings should the nurse expect? -Fatigue -Hypertension -Bradycardia -Diarrhea

-Fatigue (The nurse should identify that the client who has anemia due to blood loss following surgery will experience fatigue. This is due to the body's decreased ability carry oxygen to vital tissues and organs). !!! -Hypertension (actually hypotension) -Bradycardia (actually tachycardia) -Diarrhea (actually constipation)

A nurse is reviewing blood pressure classifications with a group of nurses at an in-service meeting. Which of the following should the nurse include as a risk factor for the development of hypertension? -High-density lipoprotein (HDL) level of 70 mg/dL -A diet high in potassium -Obstructive sleep apnea (OSA) -Taking benazepril

-High-density lipoprotein (HDL) level of 70 mg/dL (HDL is an important factor in the role of cardiovascular health and the development of hypertension. HDLs collect cholesterol from tissues and the vascular epithelium, decreasing the incidence of atherosclerosis, one of the contributing factors for the development of hypertension. The nurse should identify a low HDL level as a risk factor in the development of hypertension. However, an HDL level of 70 mg/dL places the client at a low risk for the development of hypertension and heart disease. The expected reference range for HDL is >45 mg/dL in men and >55 mg/dL in women.) -A diet high in potassium (The nurse should include diet as a factor in the development or prevention of hypertension. Low dietary potassium intake has been associated with an elevation in BP and an increased risk of stroke, while a diet high in potassium has been found to decrease blood pressure. Other electrolytes impacting blood pressure include calcium and magnesium, both of which can result in hypertension if dietary consumption is low.) -Obstructive sleep apnea (OSA) (OSA is a condition in which the client's airway becomes blocked by the relaxation of the tongue and muscles of the oropharynx, effectively obstructing the airway. The obstructed airway results in surges in the both the systolic and diastolic pressure during sleep and, in some clients, through the waking hours even when breathing is normal.) !!! -Taking benazepril (The nurse should include medications that can cause secondary hypertension such as glucocorticoids, mineralocorticoids, and sympathomimetics. Benazepril is an angiotensin-converting-enzyme (ACE) inhibitor that is used in the treatment of hypertension.)

A nurse is teaching a client about following a low-cholesterol diet after coronary artery bypass grafting. Which of the following client food choices reflects the client's understanding of these dietary instructions? -Liver -Milk -Beans -Eggs

-Liver (Liver and other organ meats are from animal sources and are therefore high in cholesterol content.) -Milk (Dairy products, including whole milk and butter, are from animal sources and therefore contain cholesterol.) -Beans (Any food that does not contain animal products does not contain cholesterol. Beans are a good source of protein for a client who follow a low-cholesterol diet.) !!! -Eggs (Egg yolks contain cholesterol. Egg whites, however, are cholesterol-free.)

A nurse on a medical-surgical unit is caring for a client who reports pain in the jaw, back, and shoulder, and shortness of breath and nausea. Which of the following actions should the nurse take? -Obtain an EKG. -Administer enteric-coated acetaminophen. -Administer ibuprofen. -Maintain oxygen saturations greater than or equal to 92%.

-Obtain an EKG. (The nurse should obtain an EKG to detect heart rhythm abnormalities within 10 min of the client's reported discomfort.) !!! -Administer enteric-coated acetaminophen. (The nurse should administer a non-enteric coated aspirin to allow for more rapid absorption of the antiplatelet medication. Acetaminophen does not have antiplatelet properties.) -Administer ibuprofen. (The nurse should administer morphine IV to provide rapid pain relief. Decreasing the client's pain level will increase oxygen supply and decrease myocardial demands for oxygen.) -Maintain oxygen saturations greater than or equal to 92%. (The nurse should administer oxygen therapy as needed to maintain oxygen saturations greater than or equal to 95% to increase myocardial oxygen supply.)

A nurse is planning a diet for client who is iron deficient. Which of the following foods high in iron should the nurse include in the plan? -Oranges -Cashews -Red meat -Yogurt

-Oranges (low in iron, but high in Vitamin C.) -Cashews (low in iron, but high in protein.) -Red meat (Good source of iron. If vegetarian, kidney beans with a high iron content are a good substitute.) !!! -Yogurt (low in iron, but good source of calcium.)

A nurse is reviewing a client's laboratory results and finds the hemoglobin is 10 g/dL and the hematocrit is 30%. The nurse recognizes that the client is at risk for which of the following? -Prolonged bleeding -Cellular hypoxia -Impaired immunity -Fluid retention

-Prolonged bleeding (The client's laboratory results indicate anemia. Thrombocytopenia, rather than anemia, places the client at risk for prolonged bleeding.) -Cellular hypoxia (The client's laboratory results indicate anemia, which places the client at risk for cellular hypoxia.) !!! -Impaired immunity (The client's laboratory results indicate anemia. Leukopenia, rather than anemia, places the clients at risk for impaired immunity.) -Fluid retention (Increased serum sodium, rather than anemia, places the client at risk for fluid retention.)

A nurse is reviewing the medical records of four older adult clients. The nurse should plan to administer the herpes zoster vaccine to which of the following?

A client who takes omeprazole for peptic ulcer disease

While auscultating a client's heart sounds, the nurse hears turbulence between the S1 and S2 heart sounds. The nurse should document this finding as which of the following?

A systolic murmur

A nurse is providing discharge teaching to a client who has peripheral arterial disease (PAD). Which of the following instructions should the nurse include in the teaching?

Adjust the thermostat so that the environment is warm.

A nurse is reviewing the BUN and creatinine levels of an older adult client who has chronic kidney disease. The nurse should expect which of the following findings?

An elevation of both BUN and creatinine is an expected finding of chronic kidney disease.

A nurse is teaching an adult client who has a low literacy level about self-administration of a subcutaneous medication. Which of the following strategies should the nurse use to promote the client's understanding?

Ask the client to demonstrate the skill

A nurse is assessing a client's cranial nerves. Which of the following methods should the nurse use to assess cranial nerve II?

Ask the client to read a Snellen chart

A nurse is assessing a client's radial pulse and determines that the pulse is irregular. Which of the following actions should the nurse take?

Assess the apical pulse for a full minute

A nurse is caring for a client who has valvular heart disease and is at risk for developing left-sided heart failure. Which of the following manifestations should alert the nurse the client is developing this condition?

Breathlessness

A nurse is teaching a client who has chronic kidney disease about the process of continuous ambulatory peritoneal dialysis (CAPD). Which of the following information should the nurse include in the teaching?

CAPD's advantages include fewer dietary and fluid restrictions as compared to hemodialysis.

A nurse in an outpatient clinic is assessing a middle adult client as part of a routine physical examination. The client's BP is 142/88mmHg, his body mass index (BMI) is 31, and he is a current smoker. The nurse should identify that this client has multiple risk factors for which of the following disorders?

Cardiovascular disease

A nurse is assisting with the admission of a client to an inpatient unit. Which of the following sources of information should the nurse rely on for accurate information about the client?

Client concerns

The family of an older adult client brings him to the emergency department after finding him wandering outside. During the initial assessment, the nurse notes that the client flinches when she palpates his abdomen yet responds to questions only by nodding and smiling. Which of the following factors should the nurse identify as a likely explanation for the client's behavior?

Confusion

A nurse is assessing for cyanosis in a client who has dark skin. Which of the following sites should the nurse examine to identify cyanosis in this client?

Conjunctivae

A nurse is assessing a client who has chronic kidney disease for fluid volume increase. Which of the following provides a reliable measure of fluid retention?

Daily weight. (Obtaining a client's daily weight and comparing it to previous weights is a reliable method for measuring a client's fluid volume over time.)

A nurse is caring for a client in the emergency department who, 2 hr earlier, severed the tip of a finger in an accident. During the assessment, the nurse detects a strong smell of alcohol from the client's breath. For which of the following findings should the nurse assess first?

Date of the client's last tetanus immunization

A nurse is preparing a presentation at a senior center about age-related musculoskeletal changes. Which of the following changes should the nurse plan to include?

Decreased muscle mass

A nurse is developing a teaching plan for a client who has a new diagnosis of type 2 diabetes mellitus. Which of the following actions should the nurse plan to take first?

Determine what the client knows about managing diabetes

A nurse is providing teaching to a client who has HTN and a new prescription for captopril. Which of the following instruction should the nurse provide?

Do not use salt substitutes while taking this medication.

A nurse is completing a client assessment for admission to the medical unit. Which of the following abdominal assessment findings require further investigation by the nurse?

Ecchymosis

A nurse is monitoring a client who has acute kidney injury. Which of the following laboratory findings should the nurse expect?

Elevated BUN. (Client who are in acute kidney injury will have an elevated BUN as damage to the kidneys leads to a build-up of nitrogenous wastes in the blood.)

A nurse is presenting information to the public about preventative measures to reduce the risk for contracting West Nile virus. Which of the following instructions should the nurse include?

Encourage the use of mosquito repellent

A nurse is providing discharge teaching to a client who has a new diagnosis of heart failure. Which of the following instruction should the nurse include in the teaching?

Exercise at least three times per week.

A nurse is preparing an older adult client for a physical examination the provider is about to perform. Which of the following actions should the nurse take?

Explain to the client what is about to happen

A nurse is caring for a client who has a new diagnosis of type 1 diabetes mellitus. To focus on effective learning with this client, which of the following interventions should the nurse use?

Explore the client's feelings about dietary modifications

A nurse is caring for an older adult client who has left-sided heart failure. Which of the following assessment findings should the nurse expect?

Frothy sputum

A nurse is caring for a client who has heart failure and a potassium level of 2.4 mEq/L. The nurse should identify which of the following medications as the cause of the client's low potassium level?

Furosemide

A nurse is caring for a client whose serum potassium level is 5.3 mEq/L. Which of the following scheduled medications should the nurse plan to administer?

Furosemide. (Furosemide results in loss of potassium from the nephron as part of its diuretic effect. This medication can be given when a client has an elevated potassium level and can lower the potassium level. For this client, the depletion of potassium is a beneficial effect. For a client who has a therapeutic potassium level, there would be a risk for hypokalemia due to the excretion of potassium.)

A nurse is assessing a client who has left-sided heart failure. Which of the following findings should the nurse expect?

Hacking cough

A nurse is preparing to teach a client who has a low literacy level. Which of the following methods should the nurse plan to include?

Have short teaching sessions

A nurse is caring for a client immediately following hemodialysis treatment. For which of the following manifestations will the nurse administer a PRN dose of phenytoin?

Headache and restlessness. (Headache and restlessness are manifestations of disequilibrium syndrome, which occurs during or after hemodialysis due to the rapid shift of fluids, pH, and osmolarity between fluid and blood that occurs.. This condition can cause cerebral edema leading to seizures and coma, and a PRN dose of the anticonvulsant phenytoin should be administered.)

A nurse is giving a presentation to a community group about preventing atherosclerosis. Which of the following should the nurse include as a modifiable risk factor for this disorder? (Select all that apply.)

Hypercholesterolemia Hypertension Obesity Smoking

A nurse is reviewing the laboratory test results from a client who has prerenal acute kidney injury (AKI). Which of the following electrolyte imbalances should the nurse expect?

Hyperkalemia. (AKI is a loss of renal function that results in a failure to maintain homeostasis. Fluid and electrolyte balance, as well as acid-base balance, are disrupted. The nurse should expect the client to have hyperkalemia due to protein breakdown and the subsequent release of intracellular potassium in to the circulation. The kidneys' inability to filter and excrete potassium results in hyperkalemia.)

A nurse is assessing a client in the oliguric phase of acute kidney injury. Which of the following findings should the nurse expect?

Hyperkalemia. (The nurse should expect the client to have an increase in the serum concentration of potassium during the oliguric phase. Potassium can rise to a life-threatening level during this phase and should be monitored closely.)

A nurse is assessing a client who has fluid overload. Which of the following findings should the nurse expect?

Increased heart rate is correct. (The nurse should expect the client who has fluid volume excess to have tachycardia and increased cardiac contractility in response to the excess fluid.) Increased blood pressure is correct. (The nurse should expect the client who has fluid volume excess to have increased blood pressure and bounding pulse in response to the excess fluid.) Increased respiratory rate is correct. (The nurse should expect the client who has fluid volume excess to have increase in respiratory rate and moist crackles heard in lungs.)

A nurse is planning home care for a 9-year-old child following an acute exacerbation of asthma. Which of the following of Erikson's developmental stages should the nurse consider in the planning?

Industry vs. Inferiority

A nurse is assessing a client's abdomen who reports stomach pain. Which of the actions should the nurse take first?

Inspect

A nurse is caring for a client who has peripheral arterial disease (PAD). Which of the following symptoms should the nurse expect to find in the early stage of the disease?

Intermittent claudication

A nurse is instructing the clients in the community about relationship development. The nurse should explain that, according to Erikson, establishing relationships with commitment is a primary task of which of the following stages of psychosocial development?

Intimacy vs. Isolation

A nurse is assessing an older adult client who has osteoporosis. Which of the following spinal deformities should the nurse expect to find in this client?

Kyphosis

A nurse is reviewing the laboratory result of a male adult client who is at risk for peripheral arterial disease from atherosclerosis. The nurse should identify that which of the following results places the client at risk?

LDL 172 mg/dL

A nurse is assessing a client who has heart failure and is prescribed furosemide. Which of the following findings is an adverse effect of this medication?

Leg cramps

A nurse is assessing a male client who has advanced peripheral artery disease (PAD). Which of the following findings should the nurse expect?

Leg pain at rest

A nurse is obtaining a medical history from a client who is requesting the herpes zoster (HZV) vaccine. The nurse should identify which of the following findings as a contraindication for receiving this vaccine.

Long-term use of prednisone for COPD

A nurse is completing a client's history and physical examination. Which of the following information should the nurse consider subjective data?

Nausea

A nurse is caring for a client who is receiving peritoneal dialysis. The nurse should monitor the client for which of the following manifestations of peritonitis?

Nausea and vomiting. (Peritonitis is an inflammation of the peritoneum and is a potential complication of peritoneal dialysis. The nurse should monitor the client for manifestations such as abdominal tenderness or pain, anorexia, nausea, vomiting, restlessness, and confusion.)

A nurse is reviewing blood pressure classifications with a group of nurses at an in-service meeting. Which of the following should the nurse include as a risk factor for the development of HTN?

Obstructive sleep apnea (OSA)

A nurse is caring for a client who has HTN and has a potassium level of 6.8 mEq/L. Which of the following actions should the nurse take?

Obtain a 12-lead ECG.

A nurse is caring for a client who has peripheral vascular disease and reports difficulty sleeping because of cold feet. Which of the following nursing actions should the nurse take to promote the client's comfort?

Obtain a pair of slipper-socks for the client.

A nurse is assessing a toddler who has heart failure. Which of the following findings should the nurse expect?

Orthopnea

A nurse is completing discharge teaching with a client. Of the following barriers to learning the nurse identifies with this client, which should the nurse interpret as a need to postpone the session?

Pain

A charge nurse is observing a nurse auscultating a client's bowel sounds. Which of the following actions requires intervention by the charge nurse?

Palpates the abdomen prior to performing auscultation

A nurse is teaching a class on health promotion and illness prevention. The nurse should include that which of the following is an example of secondary prevention?

Performing monthly breast self-examinations

A nurse is caring for a client who receives furosemide to treat heart failure. Which of the following laboratory values should the nurse monitor for this client due to this medication?

Potassium

A nurse is reviewing the laboratory data of a client following a hemodialysis treatment. The nurse should expect to find a decrease in which of the following laboratory values?

Potassium. Potassium levels are reduced by the process of diffusion during dialysis.

A nurse working in a community health center is preparing a flow sheet detailing essential screenings according to age group. At which developmental level stage on the chart should the nurse add scoliosis screening?

Pre-adolescent/Adolescent

A nurse is providing teaching to a client who has a family history of hypertension. The nurse should inform the client that his BP of 124/84 mmHg placed him in which of the following categories?

Prehypertension

A nurse is assessing a client's bowel sounds. At which of the following points in the assessment should the nurse auscultate the client's abdomen?

Prior to percussing the abdomen

A nurse is providing dietary teaching to a client who has chronic kidney disease (CKD). The nurse should instruct the client to limit which of the following nutrients?

Protein is correct. (A client who has CKD should restrict protein intake to prevent uremia that can develop as a result of the kidneys' inability to remove the waste products of protein.) Phosphorous is correct. (A client who has CKD is at risk for hyperphosphatemia due to a reduction in excretion of phosphorous by the kidneys.) Sodium is correct. (A client who has CKD is at risk for hypernatremia, edema, and hypertension due to sodium retention.)

A nurse is caring for a client who has contact dermatitis of the neck and upper chest. Which of the following is an expected finding?

Report of exposure to a skin irritant

A nurse is reviewing laboratory findings for four client. Which of the following clients has manifestations of acute kidney injury?

Serum creatinine 6 mg/dL. (This finding is above the expected reference range. The expected reference range for creatinine is 0.5 mg/dL to 1.3 mg/dL depending on the client's gender and age. An elevated serum creatinine is a manifestation of impaired kidney function, such as with acute kidney injury.)

A nurse is providing instruction to a new nurse about caring for clients who are receiving diuretic therapy to treat heart failure. The nurse should explain that which of the following medications puts the client at risk for both hyperkalemia and hyponatremia?

Spironolactone

A nurse is providing teaching to a client who has HTN and new prescription for hydrochlorothiazide. Which of the following instructions should the nurse provide?

Take the medication early in the day.

A nurse is caring for a client who has chronic renal disease and is receiving therapy with epoetin alfa. Which of the following laboratory results should the nurse review for an indication of a therapeutic effect of the medication?

The Hematocrit (Hct). (Epoetin alfa is an antianemic medication that is indicated in the treatment of clients who have anemia due to reduced production of endogenous erythropoietin, which may occur in clients who have end-stage renal disease or myelosuppression from chemotherapy. The therapeutic effect of epoetin alfa is enhanced red blood cell production, which is reflected in an increased RBC, Hgb, and Hct.)

A nurse is assessing a client who has end-stage kidney disease and is receiving hemodialysis. Which of the following findings should the nurse identify as an indiction that the client is experiencing fluid overload?

The client has a 5 lb weight gain since yesterday. (The nurse should identify that a gain of 2 lb per day is stable. A gain of more than 2 lb per day or 5 lb per week is an indication of fluid overload.)

A nurse is establishing health promotion goals for a female client who smokes cigarettes, has hypertension, and has a BMI of 26. Which of the following goals should the nurse include?

The client will walk for 30 min 5 days a week.

A nurse is assessing a client's cardiovascular system. To palpate for unexpected pulsations in the pulmonic area, at which anatomical location should the nurse place her fingers?

The left second intercostal space

A nurse is reviewing the arterial blood gas values of a client who has chronic kidney disease. Which of the following sets of values should the nurse expect?

The nurse should expect a client who has renal failure to have metabolic acidosis, which is characterized by a low HCO3-, a low pH, and a low or normal PaCO2. Expected reference ranges for these laboratory values are as follows: pH 7.35 to 7.45, HCO3- 21 to 28 mEq/L, and PaCO2 35 to 45 mm Hg.

A nurse is assessing a client's peripheral circulation. In which of the following locations should the nurse palpate to assess the posterior tibial pulse?

Third square from the top

A nurse is performing a cardiac assessment. Identify where the nurse should place the stethoscope to auscultate the client's apical pulse

Third square on the right

A nurse is providing discharge teaching about intermittent self-catheterization for a client who has benign prostatic hyperplasia. Which of the following instructions should the nurse include?

Use soap and water to wash the catheter after each use

A nurse is reviewing the medication record for a client who has chronic kidney disease. Which of the following medications should the nurse identify as having the potential to cause nephrotoxicity?

Vancomycin. (The nurse should identify that vancomycin, an antibiotic, to be associated with nephrotoxic adverse effects.)

A nurse is caring for a client who has a new diagnosis of essential HTN. The nurse should monitor the client for which of the following findings that is consistent with his diagnosis?

Vertigo

A nurse is assessing an older adult client who is sedentary plan a new exercise regimen. Which of the following activities should the nurse recommend?

Walking

A nurse is talking with a client who is beginning a program of moderate exercise. The client asks the nurse why warm-up exercises are necessary. Which of the following responses should the nurse make?

Warm-up exercises reduce the risk of injury

A nurse is caring for a client who has end-stage renal disease (ESRD). Which of the following are expected findings?

slurred speech, bone pain, tachypnea, pruritus, hypertension