Nursing practice questions with comprehensive rationales
NurseDive Free Nursing Practice Question
A 55-year-old patient with end-stage kidney disease (ESKD) is scheduled to receive a prescribed dose of epoetin alfa (Procrit). Which statement should the nurse include in her teaching about this medication?
A. "This medication will need to be stored at room temperature."
Storing the medication at room temperature is a practical instruction but does not explain the therapeutic purpose of the medication, which is essential for patient understanding.
B. "This medication is being given because your kidneys are not properly producing erythropoietin."
Epoetin alfa (Procrit) is used to treat anemia associated with chronic kidney disease by supplementing erythropoietin, a hormone the damaged kidneys can no longer produce effectively. This is the most informative statement for the patient's understanding of the medication's purpose.
C. "This medication will delay your need for dialysis as long as you take it."
While epoetin alfa can improve anemia and potentially improve quality of life, it does not directly delay the need for dialysis, which is determined by overall kidney function and not solely by the presence of anemia.
D. "This medication will help prevent your AV fistula from clotting."
Epoetin alfa does not have a role in preventing AV fistula clotting. It is specifically used to stimulate red blood cell production and has no direct effect on clotting mechanisms.
This question is an excerpt from Nurse Dive's nursing test bank - Ati Med Surg Proctored Exam Midterm Rn 36 1125. Take the full exam now
Full Explanation
Choice A rationale
Storing the medication at room temperature is a practical instruction but does not explain the therapeutic purpose of the medication, which is essential for patient understanding.
Choice B rationale
Epoetin alfa (Procrit) is used to treat anemia associated with chronic kidney disease by supplementing erythropoietin, a hormone the damaged kidneys can no longer produce effectively. This is the most informative statement for the patient's understanding of the medication's purpose.
Choice C rationale
While epoetin alfa can improve anemia and potentially improve quality of life, it does not directly delay the need for dialysis, which is determined by overall kidney function and not solely by the presence of anemia.
Choice D rationale
Epoetin alfa does not have a role in preventing AV fistula clotting. It is specifically used to stimulate red blood cell production and has no direct effect on clotting mechanisms.
Similar Questions
A nurse is caring for a client in the outpatient cardiologist's office. The client is alert and oriented. Lung sounds with crackles are heard bilaterally. Dyspnea is observed on exertion, and heart sounds reveal an S3 gallop. Which of the following findings is the nurse most likely to expect?
A. Elevated blood pressure
Elevated blood pressure is a common finding in cardiovascular conditions but is not specifically indicated by the presence of crackles, dyspnea on exertion, or an S3 gallop.
B. Decreased respiratory rate
A decreased respiratory rate is not typically associated with the presence of crackles and dyspnea; these symptoms are more indicative of increased work of breathing and potential fluid overload.
C. Pitting edema
Pitting edema is a classic sign of fluid retention, which can be associated with heart failure. The presence of crackles, dyspnea on exertion, and an S3 gallop are clinical indicators that suggest heart failure, making pitting edema a likely finding.
D. Irregular pulse
An irregular pulse may be found in various cardiac conditions but is not directly suggested by the symptoms described. The presence of an S3 gallop is more indicative of heart failure, which is commonly associated with fluid overload signs such as pitting edema.
Full Explanation
Choice A rationale
Elevated blood pressure is a common finding in cardiovascular conditions but is not specifically indicated by the presence of crackles, dyspnea on exertion, or an S3 gallop.
Choice B rationale
A decreased respiratory rate is not typically associated with the presence of crackles and dyspnea; these symptoms are more indicative of increased work of breathing and potential fluid overload.
Choice C rationale
Pitting edema is a classic sign of fluid retention, which can be associated with heart failure. The presence of crackles, dyspnea on exertion, and an S3 gallop are clinical indicators that suggest heart failure, making pitting edema a likely finding.
Choice D rationale
An irregular pulse may be found in various cardiac conditions but is not directly suggested by the symptoms described. The presence of an S3 gallop is more indicative of heart failure, which is commonly associated with fluid overload signs such as pitting edema.
A nurse is planning care for a client who has atrial fibrillation and reports heart palpitations, lightheadedness, and shortness of breath. Which of the following procedures should the nurse anticipate for this client?
A. Pericardiocentesis
Pericardiocentesis is a procedure used to remove fluid from the pericardial sac and is not typically used to treat atrial fibrillation. It is more commonly indicated for conditions such as pericardial effusion or cardiac tamponade.
B. Septal myectomy
Septal myectomy is a surgical intervention to remove part of the thickened septal wall that separates the ventricles of the heart. It is primarily used to treat hypertrophic cardiomyopathy, not atrial fibrillation.
C. Pericardial window
A pericardial window is a procedure that creates an opening in the pericardium to allow fluid to drain into the surrounding chest cavity. This procedure is not a treatment for atrial fibrillation.
D. Synchronized electrical cardioversion
Synchronized electrical cardioversion is a procedure where a controlled electric shock is delivered to the heart to restore a normal rhythm. It is a common and effective treatment for atrial fibrillation, especially when the condition is causing significant symptoms like palpitations, lightheadedness, and shortness of breath.
Full Explanation
Choice A rationale
Pericardiocentesis is a procedure used to remove fluid from the pericardial sac and is not typically used to treat atrial fibrillation. It is more commonly indicated for conditions such as pericardial effusion or cardiac tamponade.
Choice B rationale
Septal myectomy is a surgical intervention to remove part of the thickened septal wall that separates the ventricles of the heart. It is primarily used to treat hypertrophic cardiomyopathy, not atrial fibrillation.
Choice C rationale
A pericardial window is a procedure that creates an opening in the pericardium to allow fluid to drain into the surrounding chest cavity. This procedure is not a treatment for atrial fibrillation.
Choice D rationale
Synchronized electrical cardioversion is a procedure where a controlled electric shock is delivered to the heart to restore a normal rhythm. It is a common and effective treatment for atrial fibrillation, especially when the condition is causing significant symptoms like palpitations, lightheadedness, and shortness of breath.
A nurse is caring for a school-age child who has acute glomerulonephritis with peripheral edema and is producing 35 mL of urine per hour. The nurse should place the client on which of the following diets?
A. Regular diet, no added salt
A regular diet with no added salt may not be sufficient to address the fluid retention associated with acute glomerulonephritis and peripheral edema.
B. Low-protein, low-potassium diet
While a low-protein, low-potassium diet may be considered for certain kidney conditions, it does not specifically address the fluid and sodium management needed in acute glomerulonephritis with edema.
C. Low-carbohydrate, low-protein diet
A low-carbohydrate, low-protein diet is not indicated in this scenario as it does not provide the necessary restrictions on sodium and fluid that are required for a child with edema and oliguria due to acute glomerulonephritis.
D. Low-sodium, fluid-restricted diet
A low-sodium, fluid-restricted diet is most appropriate for a child with acute glomerulonephritis and peripheral edema. This diet helps manage the edema and prevent further fluid overload, which is crucial in the care of this condition.
Full Explanation
Choice A rationale
A regular diet with no added salt may not be sufficient to address the fluid retention associated with acute glomerulonephritis and peripheral edema.
Choice B rationale
While a low-protein, low-potassium diet may be considered for certain kidney conditions, it does not specifically address the fluid and sodium management needed in acute glomerulonephritis with edema.
Choice C rationale
A low-carbohydrate, low-protein diet is not indicated in this scenario as it does not provide the necessary restrictions on sodium and fluid that are required for a child with edema and oliguria due to acute glomerulonephritis.
Choice D rationale
A low-sodium, fluid-restricted diet is most appropriate for a child with acute glomerulonephritis and peripheral edema. This diet helps manage the edema and prevent further fluid overload, which is crucial in the care of this condition.