A patient with chronic kidney disease is prescribed calcium carbonate as a phosphate binder. Which instruction should the nurse provide to the patient regarding calcium carbonate administration?

Correct Answer: A

Rationale: Calcium carbonate should be taken with meals because it requires the presence of stomach acid to be properly absorbed. Taking it with meals helps ensure optimal absorption and effectiveness as a phosphate binder in patients with chronic kidney disease. Administering calcium carbonate on an empty stomach may lead to gastrointestinal side effects such as upset stomach, bloating, and constipation. Taking it with a full glass of water is also recommended to help prevent potential gastrointestinal issues and to ensure proper hydration. Crushing tablets before administration is not advised unless specifically instructed by a healthcare provider, as it can alter the drug's release and absorption properties.

Correct Answer: D

Rationale: Weight reduction is the most important focus in the health teachings provided by the nurse. Maintaining a healthy weight is crucial for overall well-being and can significantly reduce the risk of various health conditions such as heart disease, diabetes, and certain cancers. By emphasizing weight reduction, the nurse can help improve the patient's overall health and quality of life. Jogging a mile a day and vigorous exercise are beneficial for weight management, but it is important to address the root cause of potential health problems which in this case may be excess weight. Moreover, emphasizing the importance of weight reduction does not necessarily mean encouraging extreme dieting; instead, it involves promoting a balanced and healthy approach to eating and physical activity.

Correct Answer: C

Rationale: Rapid capillary refill is a sign indicative of shock in a trauma patient. Shock is a life-threatening condition where the body's organs and tissues do not receive adequate blood flow and oxygen, leading to cellular damage and eventual organ failure. In a trauma patient, rapid capillary refill suggests poor perfusion, which is a common feature of shock. The capillary refill time is an important clinical assessment that measures the time it takes for color to return to the nail bed after pressure is applied. In cases of shock, the refill time is faster than normal, indicating a systemic circulatory disturbance. Other signs of shock may include tachycardia (increased heart rate), hypotension (not hypertension), and hypothermia (not hyperthermia).

Correct Answer: A

Rationale: Myxedema is a severe form of hypothyroidism that is characterized by the accumulation of mucopolysaccharides in subcutaneous and other interstitial tissues. This condition leads to puffiness, swelling, and thickening of the skin, giving it a waxy appearance. Other symptoms of myxedema include fatigue, weight gain, cold intolerance, and hair loss. It is important to recognize and treat myxedema promptly as it can lead to serious complications such as myxedema coma, which is a life-threatening condition requiring immediate medical attention.

Correct Answer: A

Rationale: The bioethical issue described in option A revolves around the concept of advance directives. Advance directives are legal documents that outline a person's wishes regarding medical treatment in the event that they are unable to communicate those wishes themselves. In this scenario, the issue pertains to the withholding of food and treatment based on a written advance directive that was made before the patient suffered permanent brain damage. This raises important ethical considerations about respecting a patient's autonomy and adhering to their previously expressed wishes, even in difficult circumstances. The decision to withhold treatment in such a situation is a complex bioethical issue that needs to be handled carefully while balancing the principles of autonomy and beneficence.

Correct Answer: A

Rationale: Menopause is the most important risk factor for osteoporosis because it leads to a decrease in estrogen levels, which plays a crucial role in maintaining bone density. After menopause, women are at a higher risk of developing osteoporosis due to loss of estrogen's protective effects on bone mass. Other risk factors like history of previous fracture, being male, and short stature can also contribute to osteoporosis, but menopause has the strongest association with the development of the condition. It is essential for postmenopausal women to be aware of this risk factor and take preventive measures such as regular exercise, adequate calcium and vitamin D intake, and appropriate medical evaluation and treatment as needed.

Correct Answer: D

Rationale: Tipping Claudia's head back slightly helps in reaching the conjunctival sac easily. The conjunctival sac is a small space between the lower eyelid and the eye itself where eye drops are typically administered. Tilting the head back allows for better access to this area, ensuring the eye drops are delivered accurately and effectively into the eye.

Correct Answer: C

Rationale: A living will is a legal document that outlines a person's preferences and wishes regarding medical treatment, including resuscitation, in the event they become unable to communicate or make decisions. In this scenario, the client being admitted to the oncology unit wants to convey his wishes regarding resuscitation in case of cardiopulmonary arrest. A living will helps ensure that these wishes are known and respected by healthcare providers and loved ones. While a will addresses how a person's assets should be distributed after death and a health care power of attorney designates someone to make medical decisions on the person's behalf, a living will specifically focuses on healthcare preferences and treatment decisions. A proxy directive is similar to a health care power of attorney, designating someone to make healthcare decisions for the person if they are unable to do so themselves.

Correct Answer: C

Rationale: Medico-legal charts are typically stored for a minimum of 10 years after the case is closed to ensure compliance with legal requirements and to provide a comprehensive record of the medical care provided. This duration allows for potential future reference, follow-up treatment, or legal purposes that may arise within the specified timeframe. It is important to maintain these records for an extended period to protect both the patient's rights and the healthcare provider's accountability. Additionally, storing medico-legal charts for 10 years aligns with standard retention practices in the healthcare industry.