What instruction should a patient with a history of hypertension be provided when being discharged with a prescription for a thiazide diuretic?

Correct Answer: C

Rationale: Patients prescribed thiazide diuretics should monitor their weight daily to detect significant changes indicating fluid imbalance. This monitoring helps in early detection of any issues. Additionally, patients need to be cautious about potential hypokalemia and ensure they maintain adequate hydration levels to prevent complications.

Correct Answer: A

Rationale: The correct answer is A: Liver function tests. Patients on atorvastatin should have their liver function tests monitored periodically to detect any potential liver damage. Atorvastatin, a statin medication used to lower cholesterol levels, can rarely cause liver enzyme abnormalities, so regular monitoring is essential to identify any adverse effects early on.

Correct Answer: B

Rationale: The correct instruction for a patient with hypothyroidism prescribed levothyroxine is to take the medication in the morning on an empty stomach to enhance absorption. Taking it with meals can interfere with absorption. Patients should not discontinue the medication without consulting their healthcare provider as it can lead to adverse effects. Doubling the dose if a dose is missed can increase the risk of side effects and overdosage. It is crucial for patients to follow the prescribed dosing schedule and consult their healthcare provider for any concerns or missed doses.

Correct Answer: C

Rationale: The correct answer is C: Deep, rapid respirations (Kussmaul breathing). This is a sign of severe acidosis commonly seen in diabetic ketoacidosis (DKA) and requires immediate intervention. Kussmaul breathing helps to compensate for the metabolic acidosis by blowing off carbon dioxide. Prompt intervention is necessary to prevent further deterioration and potential respiratory failure.

Correct Answer: B

Rationale: Thrombocytopenia is a condition characterized by a low platelet count, which can lead to an increased risk of bleeding. To minimize this risk, patients with thrombocytopenia should avoid activities that can cause injury or bleeding, such as intramuscular injections. Encouraging light exercise can be beneficial, as it promotes circulation without increasing the risk of trauma. Aspirin should be avoided as it can further impair platelet function. Additionally, using a soft toothbrush for oral care is recommended to prevent gum bleeding in patients with thrombocytopenia.

Correct Answer: C

Rationale: Because the abuse of alcohol is a common factor associated with the development of pancreatitis, the first assessment step is to screen for alcohol use using a validated screening questionnaire. The SMAST-G is a short-form alcoholism screening instrument tailored specifically to the needs of the older adult. If the patient scores positively on the SMAST-G, then the CIWA-Ar would be a useful tool for determining treatment. The DAST-10 provides more general information regarding substance use. The Mini-Mental State Examination is used to screen for cognitive impairment.

Correct Answer: D

Rationale: The correct action for the nurse to include on the care plan for a patient with a calcium level of 12.1 mg/dL is to encourage fluid intake up to 4000 mL every day. This is essential to decrease the risk for renal calculi associated with hypercalcemia. While bed rest is not necessary, ambulation is encouraged to help decrease the loss of calcium from the bone. Monitoring for Trousseau's and Chvostek's signs is more relevant when hypocalcemia is suspected. Auscultating lung sounds every shift is a routine assessment, not required every 4 hours unless there is a specific respiratory concern.

Correct Answer: B

Rationale: The correct answer is to limit foods high in protein. Patients taking levodopa should restrict their intake of protein-rich foods because protein can interfere with the absorption of the medication. By reducing protein intake, the patient can enhance the effectiveness of levodopa therapy.

Correct Answer: C

Rationale: In clients with cirrhosis, monitoring the Prothrombin time (PT) is crucial as it assesses the blood's ability to clot. Cirrhosis can lead to impaired liver function, affecting the synthesis of clotting factors, hence increasing the risk of bleeding. Maintaining a close watch on PT levels helps in timely intervention to prevent excessive bleeding episodes.