Nokea
When teaching a client about an oral hypoglycemic medication, the nurse should place primary emphasis on
- A. recognizing findings of toxicity
- B. taking the medication at specified times
- C. increasing the dosage based on blood glucose
- D. distinguishing hypoglycemia from hyperglycemia
Correct Answer: B
Rationale: A regular interval between doses should be maintained since oral hypoglycemics stimulate the islets of Langerhans to produce insulin.
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A client returned from surgery for a perforated appendix with localized peritonitis. In view of this diagnosis, how would the nurse position the client?
- A. Prone
- B. Dorsal recumbent
- C. Semi-Fowler
- D. Supine
Correct Answer: C
Rationale: Semi-Fowler. The semi-Fowler position assists drainage and prevents spread of infection throughout the abdominal cavity.
The nurse knows that which of the following symptoms would be supportive of a diagnosis of Guillain-Barré syndrome?
- A. Hemiplegia, hypertension, tachycardia.
- B. Respiratory failure, flaccid paralysis, urinary retention.
- C. Peripheral edema, hypertension, pulmonary congestion.
- D. Diminished reflexes, pain, paresthesia.
Correct Answer: B
Rationale: Strategy: All parts of the answer choice must be correct in order for the answer to be correct. (1) relates to a CVA (2) correct-classic symptoms include respiratory failure and flaccidity due to paralysis of the muscles and urinary retention due to loss of sensation (3) relates to pulmonary edema (4) relates to peripheral nerve problems
The nurse is caring for a client with a new colostomy.
- A. What is the most appropriate teaching point for a client with a new colostomy?
- B. Change the appliance every morning.
- C. Empty the pouch when it is one-third full.
- D. Use a mild soap to cleanse the peristomal skin.
- E. Apply a skin barrier only if irritation occurs.
Correct Answer: C
Rationale: Using a mild soap to cleanse the peristomal skin prevents irritation and maintains skin integrity. Changing the appliance daily is unnecessary, emptying at one-third full prevents leaks, and a skin barrier should be used routinely to protect the skin.
Which of the following findings would indicate to the nurse that a client's Salem sump tube (nasogastric) was functioning effectively?
- A. Fluctuation of the fluid level in the water seal chamber.
- B. Active bubbling in the suction bottle.
- C. The presence of a hissing sound from the blue lumen tube.
- D. A pressure of 25 mm Hg in the esophageal balloon.
Correct Answer: C
Rationale: Strategy: Determine how each answer choice relates to a Salem sump tube. (1) Salem sump tube is not a water-sealed drainage system (2) associated with a water-sealed drainage system (3) correct-'hissing' sound is indicative that air is freely exiting the airway, purpose is to provide continuous steady suction without pulling gastric mucosa (4) is relevant to a Sengstaken-Blakemore tube
Which of the following responses by the nurse is BEST?
- A. It is best to buy new shoes in the morning.'
- B. Have each foot measured every time you buy new shoes.'
- C. Buy shoes one half size larger than your foot size so the fit is roomy.'
- D. Buy vinyl shoes because they won't lose their shape easily.'
Correct Answer: B
Rationale: Strategy: All answers are implementations. Determine the outcome of each answer choice. Is it desired? (1) should buy shoes in the afternoon when feet are larger than in the morning (2) correct-feet enlarge with age, don't break in shoes all at one time, have measurements for shoes taken while standing (feet are larger) (3) buy correct shoe size (4) leather shoes recommended because they 'breathe', vinyl could cause foot to perspire and aggravate fungal infections