A patient is admitted with a diagnosis of renal failure. He also mentions that he has stomach distress and ha ingested numerous antacid tablets over the past 2 days. His blood pressure is 110/70, his face is flushed, and he is experiencing generalized weakness. Choose the most likely magnesium (Mg ) value.

Correct Answer: A

Rationale: The correct answer is A: 11mEq/L. In renal failure, the kidneys are unable to excrete excess magnesium, leading to hypermagnesemia. The patient's symptoms of stomach distress and ingesting antacids suggest magnesium intake. A Mg level of 11mEq/L aligns with symptoms like flushed face and weakness. Choices B, C, and D are too low for hypermagnesemia symptoms and would not explain the patient's presentation.

Correct Answer: A

Rationale: The correct answer is A: Decreased resistance to infection. Lymphocytes are a crucial part of the immune system, responsible for fighting off infections. A decrease in the number of lymphocytes with age leads to a weakened immune response, making individuals more susceptible to infections. - Choice B: Cognitive problems, is not directly related to lymphocyte levels. - Choice C: Urinary incontinence, is not a typical effect of decreased lymphocytes. - Choice D: Decrease in various blood components, is too broad and not specific to the role of lymphocytes in immunity.

Correct Answer: D

Rationale: The correct answer is D: Fever. Following splenectomy, patients are at risk for OPSI due to impaired immune response. Fever is a key symptom of infection and should alert the nurse to this possibility. Bruising around the operative site (A) is expected post-surgery. Pain (B) is common after surgery and may not specifically indicate OPSI. Irritability (C) is a vague symptom and not specific to OPSI. In summary, fever is the most concerning symptom as it can indicate an underlying infection in a postsplenectomy patient.

Correct Answer: C

Rationale: Step 1: Classic full-blown AIDS presents with tumors and opportunistic infections due to severe immune system suppression. Step 2: These manifestations occur when CD4 cell count drops significantly, leading to inability to fight infections. Step 3: Persistent generalized lymphadenopathy (Choice A) can be seen in early HIV infection, not necessarily in full-blown AIDS. Step 4: Sudden weight loss, fever, and malaise (Choice B) are non-specific symptoms seen in various conditions, not specific to AIDS. Step 5: Fever, weight loss, night sweats, and diarrhea (Choice D) are common symptoms but lack the specificity of tumors and opportunistic infections seen in classic full-blown AIDS.

Correct Answer: D

Rationale: The correct answer is D. Asking about seeing halos around lights is relevant to assessing the patient's eye health as it could indicate conditions like glaucoma or cataracts. Upper respiratory infections (A), riding in a car (B), and scuba diving (C) are not directly related to eye health assessment. By focusing on symptoms directly related to the eyes, the nurse can gather relevant information for a more accurate assessment.

Correct Answer: B

Rationale: The correct answer is B: Do not stop medication abruptly. Abruptly stopping propranolol can lead to rebound hypertension and potentially life-threatening complications. The nurse should emphasize the importance of gradual tapering under medical supervision to avoid adverse effects. A: Having potassium levels checked is not directly related to propranolol use for hypertension management. C: Changes in appetite are not specific to propranolol use and may not be a significant concern compared to abrupt cessation of the medication. D: Resuming usual daily activities is important but not as crucial as the correct instruction to avoid abrupt discontinuation of propranolol.

Correct Answer: C

Rationale: The correct initial action is to choose C: Ask the patient about the facial grimacing with movement. This is important as the patient's non-verbal cues (facial grimacing) contradict their verbal pain report. By directly addressing the discrepancy, the nurse can gather more accurate information about the patient's pain experience and potentially identify any underlying issues causing the discrepancy. Proceeding to the next patient's room (A) without addressing the discrepancy would neglect the patient's needs. Assuming the patient does not want pain medicine (B) based solely on the verbal report without further assessment is premature. Administering pain medication (D) without clarifying the situation may lead to inappropriate or ineffective treatment. Therefore, option C is the most appropriate initial action to ensure comprehensive and individualized patient care.

Correct Answer: A

Rationale: The correct answer is A: Citrus fruits and green leafy vegetables. Citrus fruits and green leafy vegetables are good sources of Vitamin C and iron, which are essential for individuals with iron deficiency anemia. Vitamin C enhances the absorption of iron from plant-based sources, while green leafy vegetables provide iron. Bananas and nuts (choice B) are not significant sources of iron. Coffee and tea (choice C) can inhibit iron absorption. Dairy products (choice D) are not high in iron and can also inhibit iron absorption. Therefore, choosing citrus fruits and green leafy vegetables indicates understanding of the dietary instructions for managing iron deficiency anemia.

Correct Answer: B

Rationale: The correct answer is B: Use a low-pitched voice. This is because elderly individuals may have age-related hearing loss, making it difficult for them to hear higher frequencies. Using a low-pitched voice can help ensure that the client can hear and understand the nurse clearly. A: Leaning and shouting at the ear of the client may come across as aggressive and disrespectful. C: Opening the mouth wide while talking is not necessary and may be seen as patronizing. D: Using a medium-pitched voice may still be too difficult for the elderly client to hear clearly due to age-related hearing loss.