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BSN 266 HESI V1 DETAILED QUESTIONS WITH VERIFIED AND CORRECT ANSWERS.pdf, Exams of Medicine

BSN 266 HESI V1 DETAILED QUESTIONS WITH VERIFIED AND CORRECT ANSWERS.pdf

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BSN 266 HESI V1 DETAILED QUESTIONS
WITH VERIFIED AND CORRECT
ANSWERS
A 77 yr old female is admitted to the hospital. She is confused, has no appetite, is nauseated and vomiting, and is complaining of a headache. Her
pulse rate is 43 bpm. Which question is priority for the nurse to ask this pt or her family on admission? - answer-Does the pt take digitails?
It is important to ontain a complete medication history, the symptoms described are classic for digutails toxicity and assessment of this problem
should be made promptly.
question-The nurse is working with a 71 yr old obese pt with bilateral osteoarthritis of the hips. What recommendation should the nurse make that
is most beneficial in protecting the pt joints? - answer-Initiate a weight-reduction diet to achieve a healthy body weight.
Achieving a healthy weight is critical to protect the joints of pt with OA. Weight loss will take off the excess pressure that joints are exposed to
question-An elderly male pt comes to the geriatric screening clinic complaining of pain in his left calf. The nurse notices a reddened area on the
calf of his right leg which is warm to the touch and suspects it might be thrombophlebitis. Which type of pain would further confirm this
suspicion? - answer-Pain in the calf upon exertion which is relieved by rest and elevating the extremity.
question-In preparing to administer intravenous albumin to a client following surgery, what is the priority nursing intervention? (Select all that
apply.)
A) Set the infusion pump to infuse the albumin within four hours.
B) Compare the client's blood type with the label on the albumin.
C) Assign a UAP to monitor blood pressure q15 minutes.
D) Administer through a large gauge catheter.
E) Monitor hemoglobin and hematocrit levels.
F) Assess for increased bleeding after administration. - answer-A,d, e, f
question-A male client receives a local anesthetic during surgery. During the post-operative assessment, the nurse notices the client is slurring his
speech. Which action should the nurse take?
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BSN 266 HESI V1 DETAILED QUESTIONS

WITH VERIFIED AND CORRECT

ANSWERS

A 77 yr old female is admitted to the hospital. She is confused, has no appetite, is nauseated and vomiting, and is complaining of a headache. Her pulse rate is 43 bpm. Which question is priority for the nurse to ask this pt or her family on admission? - answer-Does the pt take digitails? It is important to ontain a complete medication history, the symptoms described are classic for digutails toxicity and assessment of this problem should be made promptly. question-The nurse is working with a 71 yr old obese pt with bilateral osteoarthritis of the hips. What recommendation should the nurse make that is most beneficial in protecting the pt joints? - answer-Initiate a weight-reduction diet to achieve a healthy body weight. Achieving a healthy weight is critical to protect the joints of pt with OA. Weight loss will take off the excess pressure that joints are exposed to question-An elderly male pt comes to the geriatric screening clinic complaining of pain in his left calf. The nurse notices a reddened area on the calf of his right leg which is warm to the touch and suspects it might be thrombophlebitis. Which type of pain would further confirm this suspicion? - answer-Pain in the calf upon exertion which is relieved by rest and elevating the extremity. question-In preparing to administer intravenous albumin to a client following surgery, what is the priority nursing intervention? (Select all that apply.) A) Set the infusion pump to infuse the albumin within four hours. B) Compare the client's blood type with the label on the albumin. C) Assign a UAP to monitor blood pressure q15 minutes. D) Administer through a large gauge catheter. E) Monitor hemoglobin and hematocrit levels. F) Assess for increased bleeding after administration. - answer-A,d, e, f question-A male client receives a local anesthetic during surgery. During the post-operative assessment, the nurse notices the client is slurring his speech. Which action should the nurse take?

A) Determine the client is anxious and allow him to sleep. B) Evaluate his blood pressure, pulse, and respiratory status. C) Review the client's pre-operative history for alcohol abuse. D) Continue to monitor the client for reactivity to anesthesia. - answer-Evaluate his BP, pulse, and respiratory status Slurred speech in the post operative client who received a local anesthesia is an atypical finding and may indicate neurological deficits that require further assessment. question-Which symptoms should the nurse expect a client to exhibit who is diagnosed with a pheochromocytoma? - answer-Headache, diaphoresis, and palpitations question-A client with diabetes mellitus is experiencing polyphagia. Which outcome statement is the priority for this client? A) Fluid and electrolyte balance. B) Prevention of water toxicity. C) Reduced glucose in the urine. D) Adequate cellular nourishment. - answer-Adequate cellular nourishment question-The nurse is teaching a female client about the best time to plan intercourse in order to conceive. Which information should the nurse provide? - answer-Two weeks before menstruation question-Which intervention should the nurse plan to implement when caring for a client who has just undergone a right above-the-knee amputation? A) Maintain the residual limb on three pillows at all times. B) Place a large tourniquet at the client's bedside. C) Apply constant, direct pressure to the residual limb. D) Do not allow the client to lie in the prone position. - answer-B) Place a large tourniquet at the client's bedside. A large tourniquet should be placed in plain sight at the client's bedside (B). If severe bleeding occurs, the tourniquet should be readily available and applied to the residual limb to control hemorrhage.

B) Smoking can decrease the quantity and quality of sperm. C) The first semen analysis should be repeated to confirm sperm counts. D) Cessation of smoking improves general health and fertility. E) Sperm specimens should be collected in 2 subsequent days. - answer-Smoking can decrease the quantity and quality of sperm (cause low testosterone levels) Cessation of smoking improves general health and fertility alcohol consumption can cause erectile dysfunction question-When teaching a client with breast cancer about the prescribed radiation therapy for treatment, what information is important to include?

  • answer-Dry, itchy skin changes may occur.

Side effects from radiation to the breast most often include temporary skin changes such as: dryness, tenderness, redness, swelling, and pruritis. question-The nurse is caring for a client with HIV who develops mycobacterium about complex. What is the most significant desired outcome for this client? - answer-Return to pre-illness weight question-The nurse is caring for a client with multiple trauma after a motor vehicle collision. The nurse learns that the client has secondary syphilis. What precaution should the nurse implement? - answer-Gloves should be worn during direct contact with the client's skin. The secondary stage of syphilis is a systemic blood-borne disease that presents with skin lesions and rashes that may drain the highly contagious spirochete, so gloves should be worn during direct contact with the client's skin. The client should be placed on contact precautions. question-The nurse is preparing a teaching plan for a client with newly diagnosed glaucoma and a history of allergic rhinitis. Which information is most important for the nurse to provide to the client about using over the counter medications for allergies? - answer-Avoid allergy medications that contain pseudoephedrine or phenylephrine question-Avoid allergy medications that contain pseudoephedrine or Phenylephrine - answer-

question-a 51 yr old truck driver who smokes two packs of cigs a day and is 30 lbs overweight is diagnosed with having a gastric ulcer. What content is most important for the nurse to include in the discharge teaching for this client? - answer-information about smoking cessation smoking has been associated with ulcer formation and stopping or decreasing the number of cigs smoked per day is an important aspect of ulcer management question-A client with gastroesophageal reflux disease (GERD) has been experiencing severe reflux during sleep. Which recommendation by the nurse is most effective to assist the client? A) Losing weight. B) Decreasing caffeine intake. C) Avoiding large meals. D) Raising the head of the bed on blocks. - answer-Raising the head of the bed on blocks. reverse Trendelenburg position to reduce reflux and subsequent aspiration is the most non-pharm effective recommendation for a client experiencing sever GERD during sleep. question-After checking the urinary drainage system for kinks in the tubing, the nurse determines that a client who has returned from the post- anesthesia care has a dark, concentrated urinary output of 54 ml for the last 2 hours. What priority nursing action should be implemented? A) Report the findings to the surgeon. B) Irrigate the indwelling urinary catheter. C) Apply manual pressure to the bladder. D) Increase the IV flow rate for 15 minutes. - answer-Report the findings to the surgeon. an adult who weighs 132 lbs, should produce about 60 ml of urine hourly. Dark concentrated and low volume or output should be reported to the surgeon. question-A client who is receiving chemotherapy asks the nurse, "Why is so much of my hair falling out each day?" Which response by the nurse best explains the reason for alopecia? A) Chemotherapy affects the cells of the body that grow rapidly, both normal and malignant. B) Alopecia is a common side effect you will experience during long-term steroid therapy.

D) Age between 25 and 55 years. - answer-Jewish European ancestry. ulcerative colitis is 4-5 times more common among Jewish european ancestry question-After the fourth dose of gentamicin sulfate (Garamycin) IV, the nurse plans to draw blood samples to determine peak and trough levels. When are the best times to draw these samples? A) 15 minutes before and 15 minutes after the next dose. B) One hour before and one hour after the next dose. C) 5 minutes before and 30 minutes after the next dose. D) 30 minutes before and 30 minutes after the next dose. - answer-5 minutes before and 30 minutes after the next dose. peak drug serum levels are achieved 30 mins after the completion of the IV infusion of gentamicin sulfate. best time to draw a trough is the closest time to the next administration question-While working in the emergency room, the nurse is exposed to a client with active tuberculosis. When should the nurse plan to obtain a tuberculin skin test? A) Immediately after the exposure. B) Within one week of the exposure. C) Four to six weeks after the exposure. D) Three months after the exposure. - answer-Four to six weeks after the exposure. question-which information about mammograms is most important to provide a post-menopausal female client? - answer-yearly mammograms should be done regardless of previous normal x-rays question-the nurse is preparing a teaching plan for a client who is newly diagnosed with type 1 diabetes mellitus. Which signs and symptoms should the nurse describe when teaching the client about hypoglycemia? - answer-sweating, trembling, tachycardia, dizziness related to the release of epinephrine as a compensatory response to low blood sugar.

question-A client with heart disease is on a continuous telemetry monitor and has developed sinus bradycardia. In determining the possible cause of the bradycardia, the nurse assesses the client's medication record. Which medication is most likely the cause of the bradycardia? A) Propanolol (Inderal). B) Captopril (Capoten). C) Furosemide (Lasix). D) Dobutamine (Dobutrex). - answer-Propanolol (Inderal). is a beta adrenergic blocking agent, which causes decreased heart rate and decreased contractility. question-A client has taken steroids for 12 years to help manage chronic obstructive pulmonary disease (COPD). When making a home visit, which nursing function is of greatest importance to this client? Assess the client's A) pulse rate, both apically and radially. B) blood pressure, both standing and sitting. C) temperature. D) skin color and turgor. - answer-temperature. question-an adult client is admitted to the hospital burn unit with partial-thickness and full thickness burns over 40% of the body. is assessing the potential for skin regeneration, what should the nurse remember about full thickness burns? - answer-regenerative function of the skin is absent because the dermal layer has been destroyed question-A client who is HIV positive asks the nurse, "How will I know when I have AIDS?" Which response is best for the nurse to provide? A) Diagnosis of AIDS is made when you have 2 positive ELISA test results. B) Diagnosis is made when both the ELISA and the Western Blot tests are positive. C) I can tell that you are afraid of being diagnosed with AIDS. Would you like for me to call your minister? D) AIDS is diagnosed when a specific opportunistic infection is found in an otherwise healthy individual. - answer-AIDS is diagnosed when a specific opportunistic infection is found in an otherwise healthy individual. question-the nurse is assessing a client who has a history of Parkinson's disease for the past 5 yrs. what symptoms would the client most likely exhibit? - answer-shuffling gait, masklike facial expressions, and tremors or the head

A) Positive polarity right shoulder, negative polarity left shoulder, ground left chest nipple line. B) Positive polarity left shoulder, negative polarity right chest nipple line, ground left chest nipple line. C) Positive polarity right chest nipple line, negative polarity left chest nipple line, ground left shoulder. D) Negative polarity left shoulder, positive polarity right chest nipple line, ground left chest nipple line. - answer-Negative polarity left shoulder, positive polarity right chest nipple line, ground left chest nipple line. question-the nurse is caring for a client with a stroke resulting in right-sided paresis and aphasia. The client attempts to use the left hand for feeding and other self care activites. The spouse becomes frustrated and insists on doing everything for the client. based on this data, which nursing diagnosis should the nurse document for this client? - answer-disabled family coping related to dissonant comping style of significant person question-Which finding should the nurse identify as most significant for a client diagnosed with polycystic kidney disease (PKD)? A) Hematuria. B) 2 pounds weight gain. C) 3+ bacteria in urine. D) Steady, dull flank pain. - answer-3+ bacteria in urine. question-a client with cirrhosis develops increasing pedal edema and ascites. What dietary modification is most important for the nurse to teach this client? - answer-restrict salt and fluid intake question-In assessing a client diagnosed with primary hyperaldosteronism, the nurse expects the laboratory test results to indicate a decreased serum level of which substance? A) Sodium. B) Antidiuretic hormone. C) Potassium. D) Glucose. - answer-Sodium. question-the nurse is planning to initiate a socialization group for older redidents of long term facility. which information would be most useful to the nurse when planning activities for the group? - answer-the usual activity patterns of each member of the group

question-an elderly client is admitted with a diagnosis of bacterial pneumonia. the nurse assessment of the client will most likely reveal which sign/symptom? - answer-confusion and tachycardia question-A client who is sexually active with several partners requests an intrauterine device (IUD) as a contraceptive method. Which information should the nurse provide? A) Using an IUD offers no protection against sexually transmitted diseases (STD), which increase the risk for pelvic inflammatory disease (PID). B) Getting pregnant while using an IUD is common and is not the best contraceptive choice. C) Relying on an IUD may be a safer choice for monogamous partners, but a barrier method provides a better option in preventing STD transmission. D) Selecting a contraceptive device should consider choosing a successful method used in the past. - answer-A) Using an IUD offers no protection against sexually transmitted diseases (STD), which increase the risk for pelvic inflammatory disease (PID). question-a client experiencing uncontrolled atrial fibrillation is admitted to the telemetry unit. What initial medication should the nurse anticipate administering to the client? - answer-digoxin (lanoxin) question-During suctioning, a client with an uncuffed tracheostomy tube begins to cough violently and dislodges the tracheostomy tube. Which action should the nurse implement first? A) Notify the healthcare provider for reinsertion. B) Attempt to reinsert the tracheostomy tube. C) Position the client in a lateral position with the neck extended. D) Ventilate client's tracheostomy stoma with a manual bag-mask. - answer-Attempt to reinsert the tracheostomy tube. question-Which client should the nurse recognize as most likely to experience sleep apnea? A) Middle-aged female who takes a diuretic nightly. B) Obese older male client with a short, thick neck. C) Adolescent female with a history of tonsillectomy. D) School-aged male with a history of hyperactivity disorder. - answer-Obese older male client with a short, thick neck. question-the nurse is receiving report from a surgery about a client with a penrose drain who is to be admitted to the postoperative unit. Before choosing a room for this client, which imformation is most important for the nurse to obtain? - answer-if the client's wound is infected

question-a 46 year old female client is admitted for acute renal failure secondary to diabetes and hypertension. Which test is the best indicator of adequate glomerular filtration? - answer-serum creatinine question-a client who has heart failure is admitted with a serum potassium level of 2.9. Which action is most important for the nurse to implement? - answer-initiate continuous cardiac monitoring question-Which description of symptoms is characteristic of a client diagnosed with trigeminal neuralgia (tic douloureux)? A) Tinnitus, vertigo, and hearing difficulties. B) Sudden, stabbing, severe pain over the lip and chin. C) Facial weakness and paralysis. D) Difficulty in chewing, talking, and swallowing. - answer-Sudden, stabbing, severe pain over the lip and chin question-The nurse is taking a history of a newly diagnosed Type 2 diabetic who is beginning treatment. Which subjective information is most important for the nurse to note? A) A history of obesity. B) An allergy to sulfa drugs. C) Cessation of smoking three years ago. D) Numbness in the soles of the feet. - answer-An allergy to sulfa drugs. question-A client has a staging procedure for cancer of the breast and ask the nurse which type of breast cancer has the poorest prognosis. Which information should the nurse offer the client? A) Stage II. B) Invasive infiltrating ductal carcinoma. C) T1N0M0. D) Inflammatory with peau d'orange. - answer-Inflammatory with peau d'orange. question-a 20 yr old female client calls the nurse to report a lump she found in her breast. Which response is the best for the nurse to provide? - answer-most lumps are benign, but it is always best to come in for an examination

question-the nurse is assessing a client's laboratory values following administration of chemotherapy. which lab value leads the nurse to suspect that the client is experiencing tumor lysis syndrome? - answer-serum calcium of 5 mg/dl question-The nurse working in a postoperative surgical clinic is assessing a woman who had a left radical mastectomy for breast cancer. Which factor puts this client at greatest risk for developing lymphedema? A) She sustained an insect bite to her left arm yesterday. B) She has lost twenty pounds since the surgery. C) Her healthcare provider now prescribes a calcium channel blocker for hypertension. D) Her hobby is playing classical music on the piano. - answer-She sustained an insect bite to her left arm yesterday. question-A client with early breast cancer receives the results of a breast biopsy and asks the nurse to explain the meaning of staging and the type of receptors found on the cancer cells. Which explanation should the nurse provide? A) Lymph node involvement is not significant. B) Small tumors are aggressive and indicate poor prognosis. C) The tumor's estrogen receptor guides treatment options. D) Stage I indicates metastasis. - answer-The tumor's estrogen receptor guides treatment options. question-what is the correct procedure for performing an opthalmoscopic examination on a client's right retina? - answer-from a distance of 12- 15 inches and slightly to the side, shine the light into the client's pupil question-A client with multiple sclerosis has experienced an exacerbation of symptoms, including paresthesias, diplopia, and nystagmus. Which instruction should the nurse provide? A) Stay out of direct sunlight. B) Restrict intake of high protein foods. C) schedule extra rest periods D) Go to the emergency room immediately. - answer-schedule extra rest periods question-A client has undergone insertion of a permanent pacemaker. When developing a discharge teaching plan, the nurse writes a goal of, "The client will verbalize symptoms of pacemaker failure." Which symptoms are most important to teach the client? A) Facial flushing.

A) Use a laryngoscope to check for a foreign body lodged in the esophagus. B) Reposition the head to validate that the head is in the proper position to open the airway. C) Turn the client to the side and administer three back blows. D) Perform a finger sweep of the mouth to remove any vomitus. - answer-Reposition the head to validate that the head is in the proper position to open the airway. question-A 57-year-old male client is scheduled to have a stress-thallium test the following morning and is NPO after midnight. At 0130, he is agitated because he cannot eat and is demanding food. Which response is best for the nurse to provide to this client? A) I'm sorry sir, you have a prescription for nothing by mouth from midnight tonight. B) I will let you have one cracker, but that is all you can have for the rest of tonight. C) What did the healthcare provider tell you about the test you are having tomorrow? D) The test you are having tomorrow requires that you have nothing by mouth tonight. - answer-The test you are having tomorrow requires that you have nothing by mouth tonight. question-A 58-year-old client who has been post-menopausal for five years is concerned about the risk for osteoporosis because her mother has the condition. Which information should the nurse offer? A) Osteoporosis is a progressive genetic disease with no effective treatment. B) Calcium loss from bones can be slowed by increasing calcium intake and exercise. C) Estrogen replacement therapy should be started to prevent the progression osteoporosis. D) Low-dose corticosteroid treatment effectively halts the course of osteoporosis. - answer-Calcium loss from bones can be slowed by increasing calcium intake and exercise. question-a female client taking oral contraceptives reports to the nurse that she is experiencing calf pain. what action should the nurse implement?

  • answer-advise the client to notify the healthcare provider for immediate medical attention question-a client with 16 year history of diabetes mellitus is having renal function test because of recent fatigue, weakness, elevated blood urea nitrogen, and serum creatinine levels. which finding should the nurse conclude as a early symptom of renal insufficiency? - answer-nocturia question-the nurse is planning care for a client with newly diagnosed diabetes mellitus that requires insulin. Which assessment should the nurse identify before beginning the teaching session? - answer-willingness of the client to learn the injection sites

question-When teaching diaphragmatic breathing to a client with chronic obstructive pulmonary disease (COPD), which information should the nurse provide? A) Place a small book or magazine on the abdomen and make it rise while inhaling deeply. B) Purse the lips while inhaling as deeply as possible and then exhale through the nose. C) Wrap a towel around the abdomen and push against the towel while forcefully exhaling. D) Place one hand on the chest, one hand the abdomen and make both hands move outward. - answer-Place a small book or magazine on the abdomen and make it rise while inhaling deeply. question-An 81-year-old male client has emphysema. He lives at home with his cat and manages self-care with no difficulty. When making a home visit, the nurse notices that his tongue is somewhat cracked and his eyeballs are sunken into his head. What nursing intervention is indicated? A) Help the client to determine ways to increase his fluid intake. B) Obtain an appointment for the client to see an ear, nose, and throat specialist. C) Schedule an appointment with an allergist to determine if the client is allergic to the cat. D) Encourage the client to slightly increase his use of oxygen at night and to always use humidified oxygen. - answer-Help the client to determine ways to increase his fluid intake. question-a client is admitted to the hospital with a medical diagnosis of pneumococcal pneumonia. the nurse knows that the prognosis for gram- negative pnemonias is very poor because - answer-gram-negative organisms are more resistant to antibiotic therapy question-a postmenopausal client asks the nurse why she is experiencing discomfort durning intercourse. What response is best for the nurse to provide? - answer-estrogen deficiency causes the vaginal tissues to become dry and thinner question-the healthcare provider prescribes aluminum and magnesium hydroxide, 1 tab po PRN for a client with chronic kidney disease who is complaining of indigestion. what intervention should the nurse implement? - answer-question the healthcare provider prescription question-In assessing a client diagnosed with primary hyperaldosteronism, the nurse expects the laboratory test results to indicate a decreased serum level of which substance? A) Sodium. B) Antidiuretic hormone. C) Potassium.

question-What discharge instruction is most important for a client after a kidney transplant? A) Weigh weekly. B) Report symptoms of secondary Candidiasis. C) Use daily reminders to take immunosuppressants. D) Stop cigarette smoking. - answer-Use daily reminders to take immunosuppressants. question-when providing discharge teaching for a client with osteoporosis, the nurse should reinforce which home care activity? - answer- elimination of hazards to home safety question-Healthcare workers must protect themselves against becoming infected with HIV. The Center for Disease Control has issued guidelines for healthcare workers in relation to protection from HIV. These guidelines include which recommendation? A) Place HIV positive clients in strict isolation and limit visitors. B) Wear gloves when coming in contact with the blood or body fluids of any client. C) Conduct mandatory HIV testing of those who work with AIDS clients. D) Freeze HIV blood specimens at - 70° F to kill the virus. - answer-Wear gloves when coming in contact with the blood or body fluids of any client. question-the nurse is assessing a client with bacterial meningitis. Which assessment finding indicates the client may have developed septic emboli? - answer-cyanosis of the fingertips question-in preparing a discharge plan for a 22 year old male client diagnosed with Buerger's disease, which referral is most important? - answer- smoking cessation program question-A splint is prescribed for nighttime use by a client with rheumatoid arthritis. Which statement by the nurse provides the most accurate explanation for use of the splints? A) Prevention of deformities. B) Avoidance of joint trauma. C) Relief of joint inflammation. D) Improvement in joint strength. - answer-Prevention of deformities.

question-the nurse is providing dietary instructions to a 68 year old client who is at high risk for development of coronary heart disease. which information should the nurse include? - answer-increase intake of soluble fiber to 10-25 grams per day question-the nurse is assessing a client who smokes cigs and has been dignosed with emphysema. which finding would the nurse expect this client to exhibit? - answer-normal skin coloring question-A client who is fully awake after a gastroscopy asks the nurse for something to drink. After confirming that liquids are allowed, which assessment action should the nurse consider a priority? A) Listen to bilateral lung and bowel sounds. B) Obtain the client's pulse and blood pressure. C) Assist the client to the bathroom to void. D) Check the client's gag and swallow reflexes. - answer-Check the client's gag and swallow reflexes. question-a client is admitted to the medical intensive care unit with a diagnosis of mycardial infarction. the clients history indicates the infraction occurred ten hours ago. which lab test result would the nurse expect this client to exhibit? - answer-elevated CK-MB question-Which milestone indicates to the nurse successful achievement of young adulthood? A) Demonstrates a conceptualization of death and dying. B) Completes education and becomes self-supporting. C) Creates a new definition of self and roles with others. D) Develops a strong need for parental support and approval. - answer-Completes education and becomes self-supporting. question-A client taking a thiazide diuretic for the past six months has a serum potassium level of 3. The nurse anticipates which change in prescription for the client? A) The dosage of the diuretic will be decreased. B) The diuretic will be discontinued. C) A potassium supplement will be prescribed. D) The dosage of the diuretic will be increased. - answer-A potassium supplement will be prescribed. question-In assessing cancer risk, the nurse identifies which woman as being at greatest risk of developing breast cancer?