After providing discharge teaching, a nurse assesses the client’s understanding regarding increased risk for metabolic alkalosis. Which statement indicates that the client needs additional teaching?
“I don’t drink milk because it gives me gas and diarrhea. ”
“I take sodium bicarbonate after every meal to prevent heartburn”.
“I have been taking digoxin every day for the last 15 years.”
“In hot weather, I sweat so much that I drink six glasses of water each day.”
The Correct Answer is B
A. “I don’t drink milk because it gives me gas and diarrhea.”: Avoiding milk due to gastrointestinal discomfort does not significantly affect acid-base balance. This behavior is not a risk factor for metabolic alkalosis and does not require further teaching.
B. “I take sodium bicarbonate after every meal to prevent heartburn.”: Regular ingestion of sodium bicarbonate can lead to excessive bicarbonate in the body, increasing the risk of metabolic alkalosis. This statement indicates a lack of understanding and the need for further teaching on safe antacid use.
C. “I have been taking digoxin every day for the last 15 years.”: Long-term digoxin use does not directly contribute to metabolic alkalosis. While monitoring for digoxin toxicity is important, this does not indicate a misunderstanding regarding alkalosis risk.
D. “In hot weather, I sweat so much that I drink six glasses of water each day.”: Sweating and replacing fluids with water alone does not significantly alter bicarbonate levels or acid-base balance, so this statement shows appropriate understanding and does not require correction.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Administer 3% NS: Hypertonic saline (3% NS) would further increase serum sodium levels, worsening hypernatremia. It is contraindicated in a client whose sodium is already critically elevated at 160 mEq/L.
B. Administer Lactated Ringers @ 100 mL/hr: Lactated Ringers contains sodium (~130 mEq/L), which would add to the hypernatremia rather than correct it. Administering it without further assessment could be harmful.
C. Administer 0.9% NS @ 100 mL/hr: Normal saline has 154 mEq/L of sodium, higher than the client’s normal range. Infusing it could exacerbate hypernatremia. Fluid selection requires careful evaluation and is not indicated based solely on this lab value.
D. Document findings in client chart: With only the serum sodium value provided and no additional assessment or orders, documenting the critical lab result is the appropriate immediate action. Further interventions should be guided by the healthcare provider after a full clinical evaluation.
Correct Answer is A
Explanation
A. “There should be no effect on my ability to reproduce”: Removal of one testis can reduce fertility, especially if there are preexisting issues with sperm count or quality. Clients should be educated about potential reproductive impact and options such as sperm banking before surgery.
B. “I can still function with one of my testes”: A single testis can typically produce sufficient testosterone and maintain sexual function, so the statement reflects correct understanding.
C. Testicular self-exam will be important on the remaining testis”: Ongoing self-examination of the remaining testis is crucial for early detection of any new abnormalities, and the client demonstrates understanding of postoperative monitoring.
D. “I will investigate sperm banking before the operation”: Planning for sperm banking shows that the client understands potential reproductive implications and is taking appropriate preoperative precautions.
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