D444 Adult Health I - Set 1 - Part 3

Correct Answer: Protein restriction

Option b is correct because protein metabolism produces urea and creatinine that failing kidneys cannot adequately filter and excrete effectively.
Option a is incorrect because carbohydrates do not produce nitrogenous waste products that accumulate in kidney disease requiring restriction typically.
Option c is incorrect because fat restriction is not specifically required in kidney disease unless managing concurrent cardiovascular disease conditions.
Option d is incorrect because fiber does not need restriction in kidney disease and may help manage constipation from fluid restrictions.

Correct Answer: Hypokalemia

Option b is correct because vomiting causes loss of hydrochloric acid and potassium, leading to metabolic alkalosis with concurrent hypokalemia.
Option a is incorrect because vomiting typically causes hyponatremia from fluid losses rather than hypernatremia unless severe dehydration occurs subsequently.
Option c is incorrect because calcium levels are not directly affected by vomiting-induced metabolic alkalosis in most clinical situations encountered.
Option d is incorrect because phosphate levels typically decrease rather than increase with vomiting and are not characteristically elevated.

Correct Answer: Neutropenic precautions

Option c is correct because CD4 count below two hundred indicates severe immunosuppression requiring neutropenic precautions to prevent opportunistic infections.
Option a is incorrect because contact precautions protect others from patient infections rather than protecting the immunocompromised patient from infections.
Option b is incorrect because droplet precautions prevent transmission from patient to others, not protection of immunocompromised patient from infections.
Option d is incorrect because standard precautions alone are insufficient for severely immunocompromised patients who need additional protective isolation measures.

Correct Answer: Mannitol intravenously

Option b is correct because intravenous mannitol rapidly reduces intraocular pressure through osmotic diuresis, critical for acute angle-closure glaucoma.
Option a is incorrect because timolol drops work slower than IV mannitol and are better for chronic management than acute crisis.
Option c is incorrect because pilocarpine drops help open drainage angle but work slower than mannitol for immediate pressure reduction needed.
Option d is incorrect because oral acetazolamide takes longer to reduce pressure compared to IV mannitol in emergency glaucoma situations.

Correct Answer: Elevated carbon dioxide level

Option b is correct because respiratory acidosis results from carbon dioxide retention above forty-five, distinguishing it from metabolic causes.
Option a is incorrect because decreased bicarbonate indicates metabolic acidosis where the body loses base, not respiratory acidosis from CO2.
Option c is incorrect because increased respiratory rate indicates compensation for metabolic acidosis, not the cause of respiratory acidosis itself.
Option d is incorrect because Kussmaul breathing is deep rapid breathing compensating for metabolic acidosis, not indicating respiratory acidosis presence.

Correct Answer: Suck on sugar-free candy

Option c is correct because sucking on sugar-free candy stimulates saliva production to relieve dry mouth without affecting medication effectiveness.
Option a is incorrect because discontinuing ipratropium removes beneficial bronchodilation effects; dry mouth is manageable without stopping medication completely.
Option b is incorrect because reducing the dose may compromise therapeutic effectiveness when side effects can be managed with simple interventions.
Option d is incorrect because dry mouth is common with anticholinergics and changing medications may not eliminate this manageable side effect.

Correct Answer: Use rescue inhaler

Option b is correct because sixty percent indicates yellow zone requiring rescue medication every four hours and healthcare provider contact.
Option a is incorrect because sixty percent is below the green zone of eighty to hundred percent where normal activities can continue.
Option c is incorrect because emergency care is indicated for red zone below fifty percent, not yellow zone at sixty percent.
Option d is incorrect because yellow zone requires active intervention with rescue medications, not just monitoring without treatment action taken.

Correct Answer: Sharing razors

Option c is correct because razors can have microscopic blood contamination, providing direct bloodborne transmission route for hepatitis B virus.
Option a is incorrect because hepatitis B is not transmitted through saliva on eating utensils unlike hepatitis A fecal-oral transmission route.
Option b is incorrect because casual kissing without blood exposure does not transmit hepatitis B which requires blood or body fluid contact.
Option d is incorrect because hepatitis B is not transmitted through toilet use as it requires direct blood contact not environmental surfaces.

Correct Answer: Avoid coughing straining

Option b is correct because coughing and straining increase intra-abdominal pressure that could disrupt the surgical wrap around the esophagus.
Option a is incorrect because encouraging coughing could damage the fundoplication wrap; gentle breathing exercises are preferred over forceful coughing.
Option c is incorrect because while ambulation is important, avoiding activities that increase abdominal pressure takes priority after fundoplication surgery.
Option d is incorrect because fluid management is less critical than preventing increased abdominal pressure that could compromise surgical repair.

Correct Answer: Increase chest expansion

Option b is correct because tripod position uses arm support to elevate shoulders, allowing accessory muscles to maximize chest expansion effectively.
Option a is incorrect because tripod positioning actually increases oxygen consumption through increased muscle use rather than decreasing it overall.
Option c is incorrect because position alone does not directly reduce carbon dioxide; it facilitates breathing mechanics for better gas exchange.
Option d is incorrect because tripod positioning addresses breathing difficulty from emphysema, not aspiration risk which requires different positioning strategies.