The nurse is caring for a patient who was admitted to the medical unit with a diagnosis of heart failure and has a history of hyperparathyroidism. The nurse reviews the following lab results in the chart below. Which order by the healthcare provider (HCP) will the nurse clarify/question?

Brain (B-Type) Natriuretic Peptide: 210 pg/mL

Potassium: 4.7 mg/dL

Calcium: 14.1 mg/dL

Sodium: 139 mEq/L

BUN: 25 mg/dL

Creatinine: 1.1 mg/dL

Administer Hydrochlorothiazide 50 mg orally daily

Monitor intake and output and daily weights

Administer Calcitonin 300 International Units (U) intramuscularly every 12 hours

Prepare the patient for possible hemodialysis

Answer and Explanation

The Correct Answer is A

Choice A reason: The order to administer Hydrochlorothiazide should be clarified because thiazide diuretics can increase calcium levels, which could worsen hypercalcemia in a patient with a history of hyperparathyroidism.

Choice B reason: Monitoring intake and output and daily weights are essential for managing fluid balance in heart failure patients and do not need clarification.

Choice C reason: Administering Calcitonin helps lower calcium levels, which is appropriate for treating hypercalcemia in a patient with hyperparathyroidism.

Choice D reason: Preparing the patient for possible hemodialysis may be necessary if the patient's kidney function deteriorates, especially with elevated BUN and creatinine levels.

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Correct Answer is C

Explanation

Choice A reason: Monitoring the patient's absolute neutrophil count (ANC) daily and stopping medication when the ANC is greater than 20,000 cells/uL is an essential aspect of using filgrastim safely. However, this is typically managed by the healthcare provider and not the primary action for the nurse to take for patient education. The nurse's role focuses more on educating the patient about potential side effects and self-care.

Choice B reason: Teaching the patient how to administer the medication via intramuscular is not relevant for filgrastim, as it is typically administered via subcutaneous injection. Proper administration technique is crucial for ensuring the medication's effectiveness, but this choice does not accurately reflect the standard administration method for filgrastim.

Choice C reason: Ensuring the patient understands the risk of bone pain and how to manage it is crucial for promoting safe and effective use of filgrastim. Bone pain is a common side effect of filgrastim due to the stimulation of bone marrow to produce more neutrophils. Educating the patient about this potential side effect and providing strategies for managing the pain, such as using over-the-counter pain relievers, helps improve patient comfort and adherence to the medication.

Choice D reason: Administering filgrastim as needed for symptoms of infection is not appropriate. Filgrastim is used to stimulate neutrophil production and prevent infection, rather than treating active infections. The medication should be administered according to the prescribed schedule, not based on the presence of infection symptoms.

A. Your family history of common bile duct disorder is a trigger for this disease. B. The frequent occurrence of blood in your stool is the main cause of your IBS. C. People with a family history of psychiatric disorders and food allergies are more likely to get IBS. D. Environmental and psychosocial factors can be associated with the onset of this disease.

Correct Answer is D

Explanation

Choice A reason: Family history of common bile duct disorder is not a known trigger for irritable bowel syndrome (IBS). IBS is a functional gastrointestinal disorder with multifactorial causes, including but not limited to genetics, gut-brain axis, and environmental factors. Bile duct disorders and IBS have different pathophysiological mechanisms and are not directly linked.

Choice B reason: The frequent occurrence of blood in the stool is not a cause of IBS. Blood in the stool is more indicative of other gastrointestinal conditions such as inflammatory bowel disease (IBD), colorectal cancer, or haemorrhoids. IBS is characterized by abdominal pain, bloating, and changes in bowel habits without organic pathology such as bleeding.

Choice C reason: While there is some evidence suggesting that individuals with a family history of psychiatric disorders and food allergies may have a higher prevalence of IBS, it is not the main cause. These factors may contribute to the onset and exacerbation of symptoms but are part of a broader spectrum of triggers, including genetics, stress, and gut microbiota.

Choice D reason: Environmental and psychosocial factors are indeed associated with the onset of IBS. Factors such as stress, anxiety, depression, and traumatic life events can play a significant role in the development and exacerbation of IBS symptoms. Additionally, environmental factors like diet, infections, and changes in gut microbiota are known to influence IBS. This choice aligns with current evidence-based understanding of the condition.

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Naxlex Comprehensive Predictor Exams

The nurse is caring for a patient receiving chemotherapy who is admitted with an absolute neutrophil count (ANC) of 459 cells/ulu. The healthcare provider orders G-CSF (filgrastim). Which action will the nurse take to promote safe and effective use of filgrastim for this patient?

Correct Answer is C

Explanation

The nurse is caring for a patient with a new diagnosis of irritable bowel syndrome (IBS). The patient is upset and concerned about how they got IBS. What evidence-based information, related to the causes of IBS, will the nurse provide to this patient?

Correct Answer is D

Explanation

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The nurse is caring for a patient with diabetic ketoacidosis (DKA). What clinical manifestations will the nurse anticipate the patient to present? (Select All That Apply)

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The nurse is administering intravenous (IV) fluids to a patient undergoing hemodialysis. Which action is most important for the nurse to take to ensure patient safety during the procedure?

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