Patient Data

Exhibits

Complete the diagram by dragging from the choices area to specify which condition the client is most likely experiencing, two actions the nurse should take to address that condition, and two parameters the nurse should monitor to assess the client's progress.

Answer and Explanation

The Correct Answer is []

• Nephrotic syndrome: The child’s rapid weight gain over two months, generalized edema, fatigue with minimal activity, and laboratory findings showing significant proteinuria, hypoalbuminemia, and mild hematuria strongly suggest nephrotic syndrome, which involves increased glomerular permeability and fluid retention.

• Administering intravenous albumin increases plasma oncotic pressure, helping to pull interstitial fluid back into the intravascular space, thereby reducing edema, improving circulatory volume, and supporting perfusion in a child with hypoalbuminemia.

• Provide a low-salt diet: Implementing a low-sodium diet is essential to help manage fluid retention associated with nephrotic syndrome, as excessive sodium intake worsens edema and may contribute to hypertension and further fluid overload.

• Daily weight: Monitoring daily weight provides a sensitive measure of fluid status and the effectiveness of therapeutic interventions, as even small changes in weight can reflect shifts in edema or fluid accumulation.

• Abdominal girth: Measuring abdominal girth regularly allows the nurse to track ascites and fluid accumulation in the peritoneal cavity, which is a common complication of nephrotic syndrome and can indicate worsening disease or inadequate response to therapy.

Rationale for Incorrect Choices:

• Type 1 diabetes: Type 1 diabetes typically presents with hyperglycemia, polyuria, polydipsia, and weight loss, none of which are observed in this child. The presence of edema and proteinuria is not consistent with diabetes.

• Hemolytic uremic syndrome: HUS is characterized by acute kidney injury, microangiopathic hemolytic anemia, and thrombocytopenia. This child does not exhibit hemolysis, platelet abnormalities, or acute renal failure, making HUS unlikely.

• Wilms' tumor: Wilms’ tumor usually presents as a palpable abdominal mass, sometimes with hematuria, but it does not cause generalized edema, proteinuria, or hypoalbuminemia, which are prominent in this child.

• Place the child on strict bed rest: Strict bed rest is unnecessary unless the child’s symptoms are severe. Children with nephrotic syndrome can maintain normal activity levels while under medical monitoring.

• Prepare the child for emergency surgery: Nephrotic syndrome is a medical condition requiring pharmacologic and dietary management, not surgical intervention; surgery is not indicated in this scenario.

• Prepare an insulin drip: There is no evidence of hyperglycemia, ketosis, or diabetes in this child, so initiating an insulin drip would be inappropriate and unrelated to the presenting condition.

• Lymph node size: Lymphadenopathy is not a feature of nephrotic syndrome, and changes in lymph node size would not provide useful information for monitoring this child’s condition or treatment response.

• Ketones: Ketone monitoring is relevant for patients with diabetes or fasting states but is not necessary in nephrotic syndrome, as ketonuria is not a feature of this disease.

• Bladder volume: Bladder monitoring is not required because there is no evidence of urinary obstruction or retention; fluid balance is better assessed by weight and urine output rather than bladder volume.

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Free Nursing Study Resources

Correct Answer is ["B","C"]

Explanation

A. Tremors: Benztropine is an anticholinergic used to reduce tremors in Parkinson’s disease, so tremors are not an expected adverse effect of this medication.

B. Urinary retention: Anticholinergic effects of benztropine can decrease bladder contractility, leading to urinary retention, which is a common side effect that clients should monitor.

C. Blurred vision: Benztropine can cause blurred vision due to its anticholinergic effect on the eyes, including pupillary dilation and impaired accommodation. Clients should be cautioned about visual changes.

D. Diarrhea is uncommon with benztropine; in fact, anticholinergic medications more often cause constipation rather than diarrhea.

E. Drooling: Benztropine reduces salivation, so drooling is not expected. The medication may actually help decrease excessive salivation associated with Parkinson’s disease.

A. Calculate the intake and output. B. Assess pulse rate. C. Monitor the temperature. D. Checking for orthostatic hypotension. E. Obtain a daily weight.

Correct Answer is ["A","E"]

Explanation

A. Calculate the intake and output: Measuring intake and output directly reflects fluid balance, making it one of the most reliable ways to determine if fluid restriction and diuretics are effective. Tracking fluid intake compared to urine output helps assess reduction in fluid overload.

B. Assess pulse rate: While monitoring pulse rate is part of routine assessment, it does not provide a clear picture of whether fluid overload is improving. Changes in pulse may occur with dehydration, arrhythmias, or other conditions, but it is not a primary measure of fluid balance.

C. Monitor the temperature: Body temperature is important for identifying infection or inflammation but does not indicate fluid status. Monitoring temperature would not help evaluate whether fluid restriction and diuretic therapy are relieving fluid overload.

D. Checking for orthostatic hypotension: Orthostatic changes can suggest hypovolemia or dehydration but are less useful for measuring the gradual effectiveness of fluid restriction. They may be monitored if over-diuresis is suspected, but they are not the best evaluation tool.

E. Obtain a daily weight: Daily weight is one of the most accurate indicators of fluid balance. A decrease in weight reflects effective removal of excess fluid, as even small weight changes can indicate significant fluid gain or loss in the body.

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Patient Data Exhibits Complete the diagram by dragging from the choices area to specify which condition the client is most likely experiencing, two actions the nurse should take to address that condition, and two parameters the nurse should monitor to assess the client's progress.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client with Parkinson's disease receives a prescription for benztropine. Which common adverse effect(s) should the nurse include in the teaching plan? Select all that apply

Correct Answer is ["B","C"]

Explanation

A client with fluid overload receives a prescription for fluid restriction of 1 liter/day and a diuretic. Which action(s) should the nurse perform to best evaluate the effectiveness of the treatment? Select all that apply.

Correct Answer is ["A","E"]

Explanation

An older male client who is admitted to a rehabilitation facility manifests signs of acute dementia. The nurse observes the client repeatedly calling out for his deceased spouse to come and get him. Which intervention(s) should the nurse implement? Select all that apply.

Patient Data Exhibits The nurse is anticipating which additional medications the healthcare provider may prescribe for the client to manage side effects while on morphine sulfate. Select the 3 medications that would be most appropriate to manage the side effects of morphine sulfate.

A client diagnosed with glaucoma receives a new prescription for dorzolamide. Prior to administering the medication, the nurse should review the electronic medical record for which allergy?

A client receives a prescription for itraconazole. Which statement made by the client requires additional instruction by the nurse?

Patient data Exhibits The nurse considers the brief interaction with the client and the triage report. Which finding(s) should the nurse investigate further? Select all that apply.

Patient Data

Exhibits

Complete the diagram by dragging from the choices area to specify which condition the client is most likely experiencing, two actions the nurse should take to address that condition, and two parameters the nurse should monitor to assess the client's progress.