A client with hyperparathyroidism is preparing for surgery. Which preoperative lab finding is most important to report?

Correct Answer: A

Rationale: In the context of a client with hyperparathyroidism preparing for surgery, the most important preoperative lab finding to report is an elevated serum calcium level (option A). Hyperparathyroidism is characterized by excessive secretion of parathyroid hormone, leading to increased calcium levels in the blood. Elevated serum calcium can lead to serious complications during surgery, such as cardiac arrhythmias and neuromuscular issues. Therefore, it is crucial to monitor and manage calcium levels closely before proceeding with surgery. Decreased serum albumin (option B) is not directly related to hyperparathyroidism or its surgical management. Albumin levels are more indicative of nutritional status and liver function. Elevated serum potassium (option C) and elevated serum magnesium (option D) are not typically associated with hyperparathyroidism. While abnormalities in these electrolytes can have implications for overall health, they are not the primary concern when managing a client with hyperparathyroidism undergoing surgery. In an educational context, understanding the significance of preoperative lab values in specific medical conditions is essential for safe and effective patient care. Nurses should be able to recognize the implications of abnormal lab findings and take appropriate actions to prevent complications during surgical procedures.

Correct Answer: D

Rationale: In the context of a colonoscopy, the most important preparation for the nurse to implement is to verify that the client has completed the bowel preparation (Option D). This step is crucial because inadequate bowel preparation can lead to poor visualization during the procedure, potentially missing important findings. Administering an enema (Option A) may not be necessary if the client has completed the prescribed bowel prep, and it can also cause discomfort and is not routinely recommended. Ensuring the client is NPO after midnight (Option B) is a general pre-procedure instruction but not specific to a colonoscopy. Encouraging the client to drink clear liquids (Option C) is important for hydration and to help clear the bowels, but ensuring completion of the bowel prep is more directly related to the success of the procedure. In an educational context, it is important for nurses to understand the rationale behind each step of a procedure to provide safe and effective care to their patients. Emphasizing the significance of proper bowel preparation for a colonoscopy can help nurses prioritize this aspect of care to optimize patient outcomes and procedural success.

Correct Answer: B

Rationale: In this scenario, the most appropriate action for the nurse to take first when a client receiving TPN reports nausea and dizziness is to check the client's vital signs and blood pressure (Option B). Checking the client's vital signs and blood pressure is crucial to assess the client's current physiological status and to determine if the symptoms of nausea and dizziness are related to any potential hemodynamic changes or complications. This immediate assessment can help the nurse identify any potential issues that require prompt intervention. Checking the client's blood glucose level (Option A) is important in clients receiving TPN, but in this situation of acute symptoms of nausea and dizziness, assessing vital signs takes priority. Decreasing the infusion rate of TPN (Option C) may be a necessary intervention, but it should be based on a comprehensive assessment that includes vital signs and blood pressure. Administering antiemetic medication as prescribed (Option D) may provide symptomatic relief, but it is essential to assess the client's vital signs first to ensure that the client's condition is stable and that the medication is safe to administer. In an educational context, it is critical for nurses to prioritize assessments based on the client's immediate needs and symptoms. Understanding the rationale behind each option helps nurses develop clinical reasoning skills to provide safe and effective patient care.

Correct Answer: C

Rationale: The correct answer is C) This medication helps improve cognitive function. Explanation: Donepezil is a cholinesterase inhibitor used to treat symptoms of Alzheimer's disease by increasing the levels of acetylcholine in the brain, which can help improve cognitive function, memory, and behavior. It does not cure Alzheimer's disease but can slow down the progression of symptoms and improve quality of life. Why the other options are wrong: A) Take the medication at bedtime for best results: The timing of medication administration is not the most important teaching point regarding donepezil. It is typically administered once daily in the morning, with or without food. B) Report any unusual changes in behavior: While important, this teaching point is more about monitoring for side effects or worsening symptoms rather than the primary purpose of the medication. D) This medication is a cure for Alzheimer's disease: This statement is incorrect. Donepezil does not cure Alzheimer's disease but rather manages symptoms and may slow down disease progression. Educational context: It is crucial for healthcare providers to educate patients and their families about the purpose and expected outcomes of medications like donepezil. Understanding the role of the medication in managing Alzheimer's disease can help set realistic expectations and improve adherence to treatment plans. Patients should be informed about the benefits and limitations of donepezil to make informed decisions about their care.

Correct Answer: D

Rationale: In the context of a client with a suspected pulmonary embolism (PE), the nurse's priority intervention should be to prepare the client for a CT scan (Option D). A CT scan is the gold standard diagnostic test for confirming the presence of a pulmonary embolism. Timely diagnosis is crucial in initiating appropriate treatment and preventing potential complications such as cardiopulmonary collapse. Administering anticoagulant therapy (Option A) is a common treatment for PE, but it should not be initiated without a confirmed diagnosis. Elevating the head of the bed (Option B) is important for optimizing respiratory function in patients with respiratory distress, but it is not the priority over confirming the diagnosis. Checking the client's oxygen saturation (Option C) is important for assessing respiratory status, but it does not address the immediate need for diagnostic confirmation in a suspected PE case. In an educational context, this question highlights the importance of prioritizing interventions based on the urgency of the situation. It reinforces the significance of diagnostic tests in guiding appropriate treatment decisions and emphasizes the critical role of nurses in advocating for timely and accurate diagnostic procedures to ensure optimal patient outcomes.