A client who is interested in smoking cessation receives teaching from a nurse. Which statements should the nurse include in this teaching? (Select ONE that does not apply)

Correct Answer: C

Rationale: The correct answer is C: Identify reasons for quitting smoking. This should not be included in the teaching because the client should already have identified their reasons for quitting before receiving the teaching. The client should have a clear understanding of why they want to quit smoking before seeking help. Choices A and B are correct as they provide practical tips to distract from smoking and avoid unhealthy behaviors. Choice D is also correct as making a list of reasons can help reinforce motivation.

Correct Answer: C

Rationale: In this scenario, the correct intervention to delegate to the student nurse is to assess the ECG strip for tall T waves (Option C). Rationale: Elevated potassium levels (hyperkalemia) can lead to serious cardiac complications, including dysrhythmias such as ventricular tachycardia or fibrillation. Tall T waves on an ECG are indicative of hyperkalemia. By delegating the task of assessing the ECG strip to the student nurse, you are allowing them to apply their knowledge of ECG interpretation to recognize a critical finding and alert the healthcare team promptly. Why other options are wrong: - Option A: Administering Kayexalate orally is not appropriate for an acute situation of hyperkalemia as it works in the intestines to exchange sodium for potassium, which is a slower process. - Option B: Spironolactone is a potassium-sparing diuretic and can further increase potassium levels, making it contraindicated in hyperkalemia. - Option D: Administering more potassium orally is contraindicated in the setting of hyperkalemia as it can exacerbate the condition. Educational context: Understanding the management of electrolyte imbalances, such as hyperkalemia, is crucial in pharmacology and medical-surgical nursing. Teaching students to recognize ECG changes associated with hyperkalemia equips them with the skills to identify and respond to critical situations promptly, promoting patient safety and quality care. This rationale provides a comprehensive explanation of the correct intervention and reinforces the importance of ECG monitoring in patients with electrolyte disturbances.

Correct Answer: D

Rationale: In this scenario, the correct answer is D) Serum magnesium 0.8 mEq/L. The reason this result is of most concern is that magnesium plays a crucial role in various physiological processes, including muscle and nerve function, regulation of blood sugar levels, and bone development. A low serum magnesium level can lead to serious complications such as arrhythmias, muscle weakness, and seizures. Therefore, prompt intervention is necessary to address this abnormality. When analyzing the other options: A) Serum potassium 5.2 mEq/L: While slightly elevated, this potassium level is within a normal range (3.5-5.0 mEq/L) and would not typically cause immediate concern. B) Serum sodium 134 mEq/L: This sodium level is within the normal range (135-145 mEq/L) and does not indicate any imminent issues. C) Serum calcium 10.6 mg/dL: This calcium level is slightly elevated, but hypercalcemia would usually present with more severe symptoms, making it less concerning than a critically low magnesium level. In an educational context, it is essential for healthcare professionals to understand the significance of abnormal laboratory results and prioritize their interpretation based on the potential impact on a patient's health. This question highlights the importance of recognizing the critical nature of certain electrolyte imbalances and the need for timely intervention to prevent adverse outcomes in patients.

Correct Answer: B

Rationale: In this scenario, the correct answer is B) Respiratory alkalosis. An elevated respiratory rate of 38 breaths per minute indicates hyperventilation, leading to excessive loss of carbon dioxide (CO2) from the body. This results in a decrease in carbonic acid concentration, leading to respiratory alkalosis. Option A) Respiratory acidosis is incorrect because it would present with a low respiratory rate and an increase in CO2 levels, leading to acidosis. Option C) Metabolic acidosis is incorrect as it is related to non-respiratory factors like renal failure or diabetic ketoacidosis. Option D) Metabolic alkalosis is incorrect as it is related to excessive loss of acid or gain of bicarbonate not due to respiratory causes. Educationally, understanding acid-base imbalances is crucial in pharmacology as it impacts drug distribution, metabolism, and elimination. Nurses need to recognize these imbalances to provide appropriate interventions and prevent complications for patients. This question highlights the importance of assessing vital signs and recognizing respiratory alkalosis based on specific clinical manifestations.

Correct Answer: B

Rationale: In this pharmacology-related question, the correct answer is B) 500 calories. This is because to lose 1 pound of body weight, a person needs to create a calorie deficit of approximately 3500 calories. Since Mr. Jones wants to lose 2 pounds per week, he would need to create a deficit of 7000 calories per week, which translates to 1000 calories per day. However, it is generally recommended not to exceed a weight loss of 2 pounds per week for health reasons. Therefore, reducing 500 calories per day would result in a safe and achievable weight loss goal for Mr. Jones. Option A) 300 calories is not sufficient to achieve the desired weight loss of 2 pounds per week. Option C) 1000 calories is actually the total weekly calorie deficit needed, not the daily deficit. Option D) 1200 calories is too aggressive and may not be sustainable or healthy for Mr. Jones in the long term. This question provides a practical application of pharmacological principles, as weight management often involves considerations of metabolic processes and energy balance. Understanding the relationship between calorie intake and weight loss is crucial for healthcare professionals when advising patients on lifestyle modifications to achieve their health goals.