Nokea
A 19-year-old male with type 1 diabetes has the flu. The nurse expects what insulin changes may be required during the illness?
- A. stopping all insulin
- B. needing more insulin
- C. needing less insulin
- D. using the same amount of insulin
Correct Answer: B
Rationale: Illness increases insulin resistance due to stress hormones, often requiring more insulin to manage hyperglycemia in type 1 diabetes.
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A client with rheumatoid arthritis tells the nurse that she is having increasing difficulty cooking, cleaning, and attending to activities of daily living. Which of the following referrals is the most appropriate?
- A. Occupational therapist.
- B. Physical therapist.
- C. Home health agency.
- D. Assisted-living facility.
Correct Answer: A
Rationale: An occupational therapist (A) helps clients with rheumatoid arthritis adapt to difficulties with daily activities through adaptive techniques and equipment. Physical therapy (B), home health (C), or assisted living (D) may be secondary.
A client with cancer received platelet infusions 24 hours ago. Which of the following assessment findings would indicate the most therapeutic effect from the transfusions?
- A. Hgb level increase from 8.9 to 10.6
- B. Temperature reading of 99.4°F
- C. White blood cell count of 11,000
- D. Decrease in oozing of blood from IV site
Correct Answer: D
Rationale: Platelet infusions aim to improve clotting. Decreased oozing from an IV site indicates effective platelet function. The other findings are unrelated to platelets.
The charge nurse is making assignments for the day. After accepting the assignment to a client with leukemia, the nurse tells the charge nurse that her child has chickenpox. Which initial action should the charge nurse take?
- A. Change the nurse's assignment to another client
- B. Explain to the nurse that there is no risk to the client
- C. Ask the nurse if the chickenpox have scabbed
- D. Ask the nurse if she has ever had the chickenpox
Correct Answer: D
Rationale: Asking if the nurse has had chickenpox determines her immunity, as non-immune nurses risk transmitting varicella to an immunocompromised leukemia patient.
The nurse is assessing a client hospitalized with duodenal ulcer. Which finding should be reported to the doctor immediately?
- A. BP 82/60, pulse 120
- B. Pulse 68, respirations 24
- C. BP 110/88, pulse 56
- D. Pulse 82, respirations 16
Correct Answer: A
Rationale: A blood pressure of 82/60 and pulse of 120 indicate possible hypovolemic shock, likely due to gastrointestinal bleeding, which is a medical emergency requiring immediate reporting.
The doctor has ordered Percocet (oxycodone) for a client following abdominal surgery. The primary objective of nursing care for the client receiving an opiate analgesic is:
- A. Preventing addiction
- B. Alleviating pain
- C. Facilitating mobility
- D. Preventing nausea
Correct Answer: B
Rationale: The primary goal of opiate analgesics like Percocet is to alleviate pain, improving comfort and recovery post-surgery.