two weeks later to evaluate his blood pressure (BP). His BP is158/106 and
he admits that he has not been taking the prescribedmedication because
the drugs make him “feel bad”. In explainingthe need for hypertension
control, the nurse should stress that anelevated BP places the client at risk
for which pathophysiologicalcondition?
a- Blindnesssecondarytocataracts
b- Acutekidney injury dueto glomerular damage
c- Strokesecondary tohemorrhage
d- Heartblock dueto myocardial damage
Rationale: Stroke related to cerebral hemorrhage is major risk
foruncontrolledhypertension.
A client with rheumatoid arthritis (RA) starts a new prescription of
etanercept(Enbrel)subcutaneouslyonceweekly.Thenurseshouldemphasizethe
importanceofreportingproblem tothehealthcareprovider?
• Headache
• Jointstiffness
• Persistentfever
• Increasehungerandthirst
• Rationale:Enbreldecreaseimmuneand
inflammatoryresponses,increasingtheclient’s risk of serious
infection, so the client should be instructed to report
apersistentfever,orothersignsofinfectiontothehealthcareprovider.
• The nurse is assessing an older adult with type 2 diabetes mellitus.
Whichassessment findingindicatesthattheclientunderstandslong-
termcontrolofdiabetes?
• The fatingblood sugarwas120mg/dlthismorning.
• Rationale: A hemoglobin A1C level reflects he average blood sugar
the client hadover the previous 2 to 3 month, and level of 6.5 g/100
ml suggest that the clientunderstand long-term diabetes control.
Normal value in a diabetic patient is up to6.5g/100 ml.
• An older male client is admitted with the medical diagnosis of possible
cerebralvascular accident (CVA). He has facial paralysis and cannot move
his left side. Whenentering the room, the nurse finds the client’s wife
tearful and trying unsuccessfully togivehimadrinkofwater. Whataction
shouldthenursetake?
• Askthewifetostopandassesstheclient’sswallowingreflex
• A 13 years-old client with non-union of a comminuted fracture of the
tibia isadmittedwithosteomyelitis.Thehealthcareprovidercollects
homeaspiratespecimensfor culture and sensitivity and applies a cast to the
adolescent’s lower leg. What actionshouldthenurseimplementnext?
• Administerantiemeticagents
• Rationale: The standard of treatment for osteomyelitis is antibiotic
therapy
andimmobilization.Afterbondandbloodaspiratespecimensareobtained
forcultureandsensitivity,the
nurseshouldinitiateparenteralantibioticsasprescribed.
• The nurse is preparing a community education program on osteoporosis.
Whichinstructionishelpfulinpreventingbonelossandpromotingboneformati
on?
• Recommendweighbearingphysicalactivity
• A client with a history of chronic pain requests a nonopioid analgesic. The
clientisalertbut hasdifficultydescribingtheexact nature
andlocationofthepaintothenurse.Whatactionshouldthenurseimplementnext?
• Administertheanalgesicasrequested
• A male client receives a thrombolytic medication following a
myocardialinfarction. When the client has a bowel movement, what
action should the nurseimplement?
• Send stoolsampletothelab foraguaiactest
• Observestoolforaday-coloredappearance.
• Obtainspecimenforcultureandsensitivityanalysis
• Assesfor fattyyellowstreaksintheclient’sstool.
• Rationale: Thrombolytic drugs increase the tendency for bleeding.
So
guaiac(occultbloodtest)testofthestoolshouldbeevaluatedtodetectblee
dingintheintestinaltract.
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