An older adult client who cares for her husband at home has just learned that she needs to have knee replacement surgery. She tells the nurse she is concerned about her inability to provide care to her husband while she recovers from surgery and attends physical therapy. She has a friend who can drive her to and from her appointments once she is discharged, but cannot provide the care her husband needs. How should the nurse respond to the client?

Tell her to consider hiring a private nurse during the postoperative convalescence.

Suggest contacting social services to help find a respite care facility for her husband.

Advise to have a case management evaluation of the client's home environment.

Recommend that the client's family return to the area to help provide assistance.

Answer and Explanation

The Correct Answer is B

A. Hiring a private nurse may be an option but is not the most immediate or practical solution given the client's current resources and concerns.

B. Suggesting contacting social services to find respite care is a practical and immediate solution to ensure her husband’s care while the client recovers.

C. A case management evaluation is helpful but may not address the immediate need for respite care during the client's recovery period.

D. Recommending that the family return might not be feasible or immediate, and respite care can provide the necessary support during recovery.

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Correct Answer is B

Explanation

In end-stage kidney failure, nephron damage is permanent and irreversible. Increasing protein does not restore kidney function.

B. Clients with end-stage kidney disease (ESKD) who are receiving dialysis require increased protein intake. Dialysis removes not only waste products but also amino acids and proteins. Without adequate protein intake, the client is at risk for malnutrition, muscle wasting, poor wound healing, and decreased energy. Therefore, protein intake is increased to replace losses and maintain nutritional status.

C. Protein restriction is appropriate in earlier stages of chronic kidney disease to reduce workload on the kidneys. However, once the client is on dialysis, protein needs increase.

D. Protein intake should be decreased to prevent the buildup of nitrogenous wastes, which the failing kidneys cannot adequately filter. Dialysis can help remove these wastes, but dietary management is still crucial.

A. Assess for symmetrical chest movement. B. Obtain a portable chest x-ray to verify ETT location. C. Monitor ETT markings between 22 and 26 cm at teeth line. D. Check for capillary refill of 3 seconds or less. E. Auscultate for presence of bilateral breath sounds.

Correct Answer is ["A","B","E"]

Explanation

A. Assessing for symmetrical chest movement helps ensure that air is moving into both lungs, indicating proper placement of the ETT.

B. Obtaining a portable chest x-ray is a definitive method to verify ETT placement in the correct position within the trachea.

C. Monitoring ETT markings is useful for tracking tube displacement over time, but it does not confirm correct placement.

D. Checking capillary refill is not relevant for confirming ETT placement; it assesses peripheral circulation.

E. Auscultating for bilateral breath sounds confirms that air is reaching both lungs, which indicates correct placement of the ETT.

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Naxlex Comprehensive Predictor Exams

The nurse is providing dietary education to a client in end stage kidney failure who requires dialysis three times a week. Which information is important for the nurse to include about the client's daily diet?

Correct Answer is B

Explanation

A young adult is brought to the emergency department after taking a handful of drugs. The client is unresponsive, so an endotracheal tube (ETT) is inserted. How should the nurse determine if the ETT is correctly placed? Select all that apply.

Correct Answer is ["A","B","E"]

Explanation

The school nurse is preparing a teaching pamphlet in response to requests from parents regarding an outbreak of pinworms at the local preschool. Which information about the most commonly prescribed medication, mebendazole, should be included?

Patient Data Exhibits Which are the 3 most important goals that would help the nurse evaluate the treatment of this client at discharge?

An older client with osteoarthritis reports increasing pain and stiffness in the right knee and asks how to reduce these symptoms. In responding to the client, the nurse recognizes what pathology as the cause of the symptoms?

An older adult client is brought to the clinic for Increased confusion over the past three days and presents with a draining wound on the right leg. Which assessment is most important for the nurse to obtain?

A client is being treated for syndrome of inappropriate antidiuretic hormone (SIADH). On examination, the client has a weight gain of 4.4 lbs (2 kg) in 24 hours and an elevated blood pressure. Which intervention should the nurse implement first?

A client with heart failure (HF) develops cardiac tamponade. The client has muffled, distant heart sounds, and is anxious and restless. After Initiating oxygen therapy and IV hydration, which intervention is most important for the nurse to implement?