The nurse is administering sevelamer (RenaGel) during lunch to a client with end-stage renal disease (ESRD). The client asks the nurse to bring the medication later. The nurse should describe which action of RenaGel as an explanation for taking it with meals?

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Question 1 of 5

The nurse is administering sevelamer (RenaGel) during lunch to a client with end-stage renal disease (ESRD). The client asks the nurse to bring the medication later. The nurse should describe which action of RenaGel as an explanation for taking it with meals?

Correct Answer: B

Rationale: The correct answer is B. Sevelamer (RenaGel) is a phosphate binder used in ESRD to bind with phosphorus in foods, preventing its absorption in the gastrointestinal tract. This is important as ESRD patients often have high levels of phosphorus in their blood, which can lead to complications like cardiovascular disease. Taking RenaGel with meals ensures that it binds with phosphorus in the food, reducing its absorption. Choice A is incorrect as RenaGel does not prevent indigestion associated with spicy foods. Choice C is incorrect as RenaGel does not promote stomach emptying or prevent gastric reflux. Choice D is incorrect as RenaGel does not buffer hydrochloric acid or prevent gastric erosion.

Question 2 of 5

Following a CVA, the nurse assesses that a client has developed dysphagia, hypoactive bowel sounds, and a firm, distended abdomen. Which prescription for the client should the nurse question?

Correct Answer: A

Rationale: The correct answer is A: Continuous tube feeding at 65 ml/hr via gastrostomy. After a CVA, dysphagia, hypoactive bowel sounds, and a firm, distended abdomen indicate a risk for aspiration and bowel obstruction. Continuous tube feeding may worsen these issues. Option B provides nutrition intravenously, bypassing the gastrointestinal tract. Option C helps decompress the stomach. Option D is a medication to help with GI motility. Therefore, the nurse should question option A due to the risk of complications post-CVA.

Question 3 of 5

A client's telemetry monitor indicates the sudden onset of ventricular fibrillation. Which assessment finding should the nurse anticipate?

Correct Answer: D

Rationale: The correct answer is D: No palpable pulse. Ventricular fibrillation is a life-threatening arrhythmia where the heart quivers and doesn't effectively pump blood. This results in the absence of a palpable pulse. The nurse should anticipate this finding as it indicates a severe cardiac emergency requiring immediate intervention. Choices A, B, and C are incorrect because ventricular fibrillation leads to ineffective heart contractions, causing a lack of pulse rather than bounding, irregular, or thready pulses. It is crucial for the nurse to recognize the absence of a palpable pulse to initiate prompt resuscitative measures.

Question 4 of 5

While assessing a 70-year-old female client with Alzheimer's disease, the nurse notes deep inflamed cracks at the corners of her mouth. What intervention should the nurse include in this client's plan of care?

Correct Answer: D

Rationale: The correct answer is D because deep inflamed cracks at the corners of the mouth can be a sign of vitamin B deficiency, specifically B2 (riboflavin) or B3 (niacin). Ensuring the client gets adequate B vitamins through foods or supplements can help address the deficiency and improve the condition. Option A is incorrect as simply applying a moisturizing cream does not address the underlying cause. Option B is not the best choice because while vitamin B-rich foods are beneficial, they may not be sufficient to correct a deficiency. Option C is not the immediate priority unless there are other concerning symptoms present.

Question 5 of 5

A young adult female client is seen in the emergency department for a minor injury following a motor vehicle collision. She states she is very angry at the person who hit her car. What is the best nursing response?

Correct Answer: C

Rationale: The correct answer is C: "You are upset that this incident has brought you here." This response acknowledges the client's feelings of anger and validates her emotions, showing empathy and understanding. It demonstrates active listening and therapeutic communication, which is crucial in building trust and rapport with the client. Choice A is incorrect as it dismisses the client's feelings of anger and invalidates her emotions by shifting the focus to being grateful instead. Choice B is incorrect as it minimizes the client's emotional response by focusing on the material aspect of the situation rather than addressing her feelings. Choice D is incorrect as it does not address the client's emotional state and is a closed-ended question that does not encourage further discussion or exploration of the client's feelings.

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