NCLEX-PN Quizlet 2023 - Nurselytic

Correct Answer: B

Rationale: In the context of DIC, effective Heparin therapy aims to halt the process of intravascular coagulation. One of the indicators of a positive response to Heparin therapy is an increase in fibrinogen levels. Heparin interferes with the conversion of fibrinogen to fibrin by thrombin. This interruption helps increase the availability of fibrinogen. While the platelet count may increase due to improved clotting, the primary focus of Heparin therapy is on fibrinogen. Fibrin split products are expected to decrease as the coagulation cascade is controlled. Although decreased bleeding is an ultimate goal, the immediate effect of Heparin is not directly on bleeding but on the coagulation process.

Correct Answer: B

Rationale: A client with renal insufficiency should not start a low CHO diet because it could result in an increased renal solute load. Clients with renal or liver disease require protein control in their diet to prevent complications. Proteins used must be of high biologic value, and protein intake is usually weight-based. Protein levels may be adjusted based on the client's clinical condition. A minimum level of carbohydrates is needed in the diet to spare protein. Vitamin and mineral supplements might be needed for clients with liver failure. The dietician plays a crucial role in calculating specific nutrient requirements for these clients and monitoring outcomes in conjunction with the healthcare team.
Choice A is incorrect because simply consuming a minimum amount of carbohydrates does not address the issue of increased renal solute load.
Choice C is incorrect as calcium supplements are not the primary concern when considering a low CHO diet for a client with renal insufficiency.
Choice D is incorrect as the focus should be on the contraindication of a low CHO diet for a client with renal insufficiency rather than just high biologic protein sources.

Correct Answer: C

Rationale: The correct answer is to implement reverse isolation. Reverse isolation is a protective measure used to protect patients from infections, not to affect the risk of hemorrhage. Testing all excreta for occult blood (
Choice
A) is important to monitor for signs of internal bleeding. Using a soft toothbrush or foam cleaner for oral hygiene (
Choice
B) is recommended to prevent gum bleeding. Avoiding IM injections (
Choice
D) is crucial to reduce the risk of bleeding in a client with a low platelet count.
Therefore, among the given options, implementing reverse isolation is the least likely to increase the risk of hemorrhage.

Correct Answer: A

Rationale: Erythropoietin is necessary for red blood cell (RB
C) production, and in clients with renal failure who lack endogenous erythropoietin, exogenous erythropoietin is administered. However, for erythropoietin to effectively stimulate RBC production, adequate levels of iron, folic acid, and vitamin B12 are crucial. These nutrients are essential for RBC synthesis and maturation.
Therefore, the correct answer is to give iron, folic acid, and B12 with erythropoietin.
Choice B, an increase in protein in the diet, is not necessary for RBC production and may exacerbate uremia in clients with renal failure.

Choices C and D, vitamins A and C, and an increase in calcium in the diet, respectively, are not directly related to RBC production and are not required to enhance the effectiveness of erythropoietin.

Correct Answer: B

Rationale: The correct answer is a hyperglycemic patient. The signs described - weak pulse, quick respiration, acetone breath, and nausea - are indicative of hyperglycemia. A hypoglycemic patient would typically present with different signs such as pale skin, sweating, and confusion. Cardiac arrest would manifest with sudden loss of heart function and consciousness, not the signs described. End-stage renal failure would present with symptoms related to kidney dysfunction like edema, fatigue, and changes in urine output, which are not mentioned in the scenario.