The nurse is caring for a patient who was admitted to the medical unit with a diagnosis of heart failure and has a history of hyperparathyroidism. The nurse reviews the following lab results in the chart below. Which order by the healthcare provider (HCP) will the nurse clarify/question?

Brain (B-Type) Natriuretic Peptide: 210 pg/mL

Potassium: 4.7 mg/dL

Calcium: 14.1 mg/dL

Sodium: 139 mEq/L

BUN: 25 mg/dL

Creatinine: 1.1 mg/dL

Administer Hydrochlorothiazide 50 mg orally daily

Monitor intake and output and daily weights

Administer Calcitonin 300 International Units (U) intramuscularly every 12 hours

Prepare the patient for possible hemodialysis

Answer and Explanation

The Correct Answer is A

Choice A reason: The order to administer Hydrochlorothiazide should be clarified because thiazide diuretics can increase calcium levels, which could worsen hypercalcemia in a patient with a history of hyperparathyroidism.

Choice B reason: Monitoring intake and output and daily weights are essential for managing fluid balance in heart failure patients and do not need clarification.

Choice C reason: Administering Calcitonin helps lower calcium levels, which is appropriate for treating hypercalcemia in a patient with hyperparathyroidism.

Choice D reason: Preparing the patient for possible hemodialysis may be necessary if the patient's kidney function deteriorates, especially with elevated BUN and creatinine levels.

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Correct Answer is A

Explanation

Choice A reason: Ondansetron is an antiemetic given to control nausea and vomiting, which are common symptoms in patients with inflammatory bowel disease, especially when they have a flare-up.

Choice B reason: Vitamin B12 injections are crucial for preventing pernicious anemia but are not specific treatments for acute management of inflammatory bowel disease symptoms.

Choice C reason: Antidiarrheal medications should be used cautiously in inflammatory bowel disease as they can worsen symptoms or lead to complications like toxic megacolon.

Choice D reason: Beta-adrenergic blockers are not used to reduce bowel motility and are not a part of the standard treatment regimen for inflammatory bowel disease.

A. The patient is increasingly drowsy and hard to arouse. B. The patient's feet and hands are covered with red, raised purpura.

Correct Answer is A

Explanation

Choice A reason: The patient being increasingly drowsy and hard to arouse is an urgent finding that should be reported immediately. This condition may indicate intracranial bleeding or other severe complications related to extremely low platelet count (10,000/mm³) in idiopathic thrombocytopenic purpura (ITP). Immediate medical intervention is required to prevent further deterioration.

Choice B reason: Red, raised purpura on the patient's feet and hands is a concerning finding indicative of significant thrombocytopenia, but it is not as immediately life-threatening as decreased consciousness. It should still be monitored and managed, but the priority is the patient's level of consciousness.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is assessing a patient who is diagnosed with inflammatory bowel disease and is requiring inpatient treatment at a hospital. What medication will the nurse provide when caring for this patient?

Correct Answer is A

Explanation

The nurse is caring for a patient with idiopathic thrombocytopenic purpura (ITP) whose platelet count is 10,000/mm³. What assessment finding will the nurse report to the provider immediately?

Correct Answer is A

Explanation

The nurse is teaching the patient about the medication albuterol for the treatment of chronic obstructive pulmonary disease (COPD). Which medication adverse effect will the nurse teach the patient to monitor for and report?

The nurse is caring for a patient with diabetic ketoacidosis. Which assessment finding indicates to the nurse that the patient is experiencing fluid volume deficit?

The nurse is caring for a patient with a history of chronic kidney disease who was admitted with hypervolemia. As part of discharge planning, which instruction will the nurse provide to help the patient accurately monitor their fluid balance?

The nurse is caring for a patient with type 2 diabetes who has been diagnosed with hyperglycemic hyperosmolar syndrome. What clinical manifestation will the nurse expect to find in this patient?

The nurse is caring for a patient with chronic kidney disease (CKD) who is at risk for renal osteodystrophy. Which intervention will the nurse implement to manage this condition?

The nurse is observing a patient using a metered-dose inhaler (MDI) to aid in the management of chronic obstructive pulmonary disease (COPD). Which of the following actions, performed by the patient, indicate that further instruction is needed?

The nurse is caring for a patient with diabetic ketoacidosis (DKA). What clinical manifestations will the nurse anticipate the patient to present? (Select All That Apply)

The nurse is caring for a patient after a recent kidney transplant. What statement will the nurse include when teaching the patient about preventing organ rejection?