A healthcare professional is reviewing the arterial blood gas results for a client in the ICU who has kidney failure and determines the client has respiratory acidosis. Which of the following findings should the healthcare professional expect?

Correct Answer: A

Rationale: The correct answer is A: Widened QRS complexes. Respiratory acidosis results from inadequate removal of carbon dioxide, leading to increased carbonic acid in the blood and a decrease in blood pH. This acidosis can cause electrolyte imbalances, including hyperkalemia, which can manifest as widened QRS complexes on an ECG due to the effect of high potassium levels on cardiac conduction. Hyperactive deep tendon reflexes (B) are associated with conditions such as hyperthyroidism or hypocalcemia. Bounding peripheral pulses (C) are seen in conditions like aortic regurgitation or hyperthyroidism. Warm, flushed skin (D) is more indicative of conditions like hyperthermia or sepsis.

Correct Answer: B

Rationale: In this scenario, the correct action to take is to review the client's morning calcium level (Option B). This is because the client is exhibiting signs of hypocalcemia, which can manifest as decreased blood pressure, heart rate, and facial twitching. Calcium plays a crucial role in cardiac function and neuromuscular excitability, so monitoring calcium levels is essential in this situation. Option A (Reassess the client’s blood pressure and heart rate) could be a temporary measure, but it does not address the underlying cause of the symptoms. Option C (Request a neurologic consult today) is not the immediate priority because the symptoms are more indicative of a metabolic issue like hypocalcemia rather than a primary neurological problem. Option D (Check the client's pupillary reaction to light) is not relevant to the symptoms presented and does not address the potential hypocalcemia. In an educational context, this question highlights the importance of recognizing and responding to electrolyte imbalances such as hypocalcemia promptly. Understanding the clinical manifestations of various electrolyte disturbances is crucial for nurses to provide safe and effective care to their patients. By choosing the correct intervention, nurses can help prevent further complications and promote positive patient outcomes.

Correct Answer: A

Rationale: In the context of a client with diabetic ketoacidosis (DKA), delegating the task of checking the fingerstick glucose every hour to the nursing assistant is appropriate. This task does not require advanced clinical judgment or interpretation of results and falls within the scope of practice for a nursing assistant. Monitoring glucose levels closely is crucial in managing DKA as it helps in assessing the effectiveness of treatment and detecting any fluctuations promptly. Recording intake and output every hour, checking vital signs every 15 minutes, and assessing for indicators of fluid imbalance are tasks that require a higher level of clinical judgment and interpretation, thus should not be delegated to a nursing assistant. These activities involve assessing for subtle changes in the patient's condition, which necessitates a deeper understanding of the pathophysiology of DKA and its potential complications. Educationally, understanding the rationale behind delegation in the context of DKA is essential for nurses to provide safe and effective care. It underscores the importance of matching tasks with the appropriate skill level of personnel to optimize patient outcomes and prevent errors. Nurses need to prioritize tasks based on the complexity and criticality of the situation, ensuring that each team member functions within their scope of practice to deliver comprehensive care.

Correct Answer: D

Rationale: In the context of pharmacology and medical-surgical care, understanding the factors that contribute to a long and healthy life is essential for healthcare professionals. The correct answer, "D) Interest in life," is rooted in the concept of psychosocial well-being and its impact on overall health. Having a genuine interest in life promotes mental and emotional health, which in turn can positively influence physical well-being. This option emphasizes the importance of maintaining a positive outlook, engaging in activities that bring joy and fulfillment, and fostering social connections. Option A, "A diet high in animal fat, cholesterol, and calories," is incorrect because such a diet is associated with various health risks, including cardiovascular disease, obesity, and metabolic disorders. Healthcare providers emphasize the importance of a balanced diet rich in fruits, vegetables, whole grains, and lean proteins for optimal health. Option B, "Early retirement from work," is incorrect as there is no direct correlation between retirement age and longevity. Factors such as financial stability, social engagement, and continued intellectual stimulation play a more significant role in overall health and well-being. Option C, "Vigorous physical activity once a week," while promoting exercise, is not sufficient for maintaining a long and healthy life. Regular physical activity, along with a balanced diet, adequate sleep, stress management, and preventive healthcare measures, are key components of a healthy lifestyle. Educationally, this question underscores the holistic approach to healthcare, highlighting the interconnectedness of physical, mental, and emotional well-being in promoting longevity and quality of life. It emphasizes the significance of psychosocial factors in health outcomes and reinforces the importance of patient-centered care that addresses the diverse needs of individuals beyond just physical symptoms.

Correct Answer: C

Rationale: In the context of pharmacology and weight reduction programs, option C - "Personal eating habits must be assessed objectively" is the correct choice. This option is essential to the success of Mrs. Allen's weight reduction program as it emphasizes the importance of understanding her current eating habits. By objectively assessing her eating patterns, preferences, and behaviors, the nurse can tailor a personalized and sustainable weight loss plan for her. Option A, recommending the use of an anorexiant for 4-6 weeks at the beginning, is incorrect because using such medications for weight loss can have serious side effects and should only be considered in specific cases under strict medical supervision. Option B, suggesting an intestinal bypass if rapid weight loss is not achieved, is also incorrect as surgical interventions like bypass surgeries are typically considered only after other non-invasive methods have been attempted and failed. Option D, advocating for complete fasting for a week, is not recommended as it can lead to nutritional deficiencies, metabolic imbalances, and is generally unsustainable in the long term. Educationally, understanding the rationale behind the correct choice reinforces the importance of a holistic approach to weight management, focusing on individualized assessments and interventions rather than quick-fix solutions or extreme measures. It highlights the significance of considering a patient's current habits and lifestyle factors in developing a successful weight reduction plan that promotes long-term health and well-being.