Nursing practice questions with comprehensive rationales
NurseDive Free Nursing Practice Question
The nurse is caring for a client admitted with acute diverticulitis. Which would the nurse anticipate the healthcare provider ordering for this client?
A. Albumin and furosemide
Albumin and furosemide treat fluid shifts or edema, not acute diverticulitis, which requires bowel rest, not volume or protein correction initially.
B. A high fiber diet with increased fluid intake
High fiber aids chronic diverticulosis, but in acute diverticulitis, it worsens inflammation; rest, not fiber, is needed during active infection.
C. Maintain NPO and IV fluids
NPO and IV fluids rest the bowel, reducing inflammation and perforation risk in acute diverticulitis, while maintaining hydration, the standard approach.
D. Obtain a consent for a barium enema
Barium enema risks perforation in acute diverticulitis due to inflamed diverticula; it’s contraindicated until inflammation subsides, not ordered acutely.
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Full Explanation
Choice A reason: Albumin and furosemide treat fluid shifts or edema, not acute diverticulitis, which requires bowel rest, not volume or protein correction initially.
Choice B reason: High fiber aids chronic diverticulosis, but in acute diverticulitis, it worsens inflammation; rest, not fiber, is needed during active infection.
Choice C reason: NPO and IV fluids rest the bowel, reducing inflammation and perforation risk in acute diverticulitis, while maintaining hydration, the standard approach.
Choice D reason: Barium enema risks perforation in acute diverticulitis due to inflamed diverticula; it’s contraindicated until inflammation subsides, not ordered acutely.
Similar Questions
A nurse is assessing a client who is receiving levothyroxine for treatment of hypothyroidism. The nurse should recognize which of the following findings is a therapeutic response to this medication?
A. Decrease in body temperature
Decreased body temperature reflects hypothyroidism; levothyroxine raises metabolism, normalizing or increasing temperature, so this isn’t a therapeutic response.
B. Increase in energy
Increased energy occurs as levothyroxine restores thyroid hormone, boosting metabolism, reversing hypothyroidism’s fatigue, a key sign of effective treatment.
C. Increase in weight
Weight gain contradicts levothyroxine’s effect; it increases metabolism, aiding weight loss or stabilization, not gain, in hypothyroidism treatment.
D. Decrease in appetite
Decreased appetite isn’t typical; levothyroxine may normalize appetite as metabolism rises, not suppress it, differing from hypothyroidism’s effects.
Full Explanation
Choice A reason: Decreased body temperature reflects hypothyroidism; levothyroxine raises metabolism, normalizing or increasing temperature, so this isn’t a therapeutic response.
Choice B reason: Increased energy occurs as levothyroxine restores thyroid hormone, boosting metabolism, reversing hypothyroidism’s fatigue, a key sign of effective treatment.
Choice C reason: Weight gain contradicts levothyroxine’s effect; it increases metabolism, aiding weight loss or stabilization, not gain, in hypothyroidism treatment.
Choice D reason: Decreased appetite isn’t typical; levothyroxine may normalize appetite as metabolism rises, not suppress it, differing from hypothyroidism’s effects.
Which electrolyte will be high in a client with hypoparathyroidism?
A. Phosphorus
Hypoparathyroidism lowers PTH, reducing phosphorus excretion, raising serum levels as kidneys reabsorb more, while calcium drops, a classic imbalance.
B. Calcium
Calcium decreases in hypoparathyroidism due to low PTH, impairing bone resorption and gut absorption, opposite to being high, so this is incorrect.
C. Magnesium
Magnesium isn’t directly regulated by PTH; hypoparathyroidism doesn’t consistently elevate it, staying normal unless other factors intervene.
D. Potassium
Potassium is unaffected by hypoparathyroidism, controlled by aldosterone and kidneys, not PTH, so it doesn’t rise with this condition.
Full Explanation
Choice A reason: Hypoparathyroidism lowers PTH, reducing phosphorus excretion, raising serum levels as kidneys reabsorb more, while calcium drops, a classic imbalance.
Choice B reason: Calcium decreases in hypoparathyroidism due to low PTH, impairing bone resorption and gut absorption, opposite to being high, so this is incorrect.
Choice C reason: Magnesium isn’t directly regulated by PTH; hypoparathyroidism doesn’t consistently elevate it, staying normal unless other factors intervene.
Choice D reason: Potassium is unaffected by hypoparathyroidism, controlled by aldosterone and kidneys, not PTH, so it doesn’t rise with this condition.
During thyroid surgery, the client's parathyroid glands have been damaged. Which condition does the nurse expect the client to develop?
A. Thyroid cancer
Thyroid cancer involves malignant thyroid growth, not a consequence of parathyroid damage during surgery, which affects calcium, not cancer risk.
B. Goiter
Goiter is thyroid enlargement from iodine issues or hyperplasia, unrelated to parathyroid damage, which controls calcium, not thyroid size.
C. Graves' disease
Graves’ disease, hyperthyroidism, results from autoantibodies, not parathyroid injury, which causes hypocalcemia, not thyroid hormone excess.
D. Tetany
Parathyroid damage reduces PTH, dropping calcium levels, leading to tetany—muscle spasms from hypocalcemia, a direct surgical complication.
Full Explanation
Choice A reason: Thyroid cancer involves malignant thyroid growth, not a consequence of parathyroid damage during surgery, which affects calcium, not cancer risk.
Choice B reason: Goiter is thyroid enlargement from iodine issues or hyperplasia, unrelated to parathyroid damage, which controls calcium, not thyroid size.
Choice C reason: Graves’ disease, hyperthyroidism, results from autoantibodies, not parathyroid injury, which causes hypocalcemia, not thyroid hormone excess.
Choice D reason: Parathyroid damage reduces PTH, dropping calcium levels, leading to tetany—muscle spasms from hypocalcemia, a direct surgical complication.