Nokea
A 20-year-old obese female client is preparing to have gastric bypass surgery for weight loss. She says to the nurse, 'I need this surgery because nothing else I have done has helped me to lose weight.' Which response by the nurse is most appropriate?
- A. If you eat less, you can save some money.'
- B. Exercise is a healthier way to lose weight.'
- C. You should try the Atkins diet first.'
- D. I respect your decision to choose surgery.'
Correct Answer: D
Rationale: This statement is most appropriate, as it shows respect and empathy. The other statements are both insensitive and unprofessional.
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The client has an order for 0.45 mg Diltiazem. The medication vial has a concentration of 3 mg/mL. How many mL of the drug should be administered?
- A. 0.15 mL
- B. 6.6 mL
- C. 1.5 mL
- D. 0.65 mL
Correct Answer: A
Rationale: The correct calculation is 0.45 / 3 which equals 0.15 mL.
The client who is to receive a scheduled dose of digoxin has an irregular apical pulse at 92 bpm and a serum potassium of 3.9 mEq/L. Which nursing documentation reflects the most appropriate action?
- A. Serum potassium level WNL. Digoxin given for rapid apical pulse.
- B. Digoxin withheld because the client's apical heart rate is irregular.
- C. Digoxin withheld to prevent toxicity due to the low potassium level.
- D. HCP informed of irregular heart rate and low serum potassium level.
Correct Answer: A
Rationale: A: A normal serum potassium level is 3.5 to 5.0 mEq/L. Digoxin (Lanoxin), a cardiac glycoside, slows and strengthens the heart. It is used for rate control in clients with atrial fibrillation, which often produces an irregular rhythm. B: Dysrhythmias can occur if digoxin is given when the serum potassium level is low, but the serum potassium level is WNL. Digoxin is used for rate control and would not be withheld due to an irregular HR. C: Although it is important to monitor for digoxin toxicity, the serum potassium level is WNL. D: Withholding digoxin and notifying the HCP are unnecessary; the serum potassium is WNL.
The LPN is caring for a 9 month-old infant. Which of these behaviors exhibited by the child warrants further investigation?
- A. She prefers crawling and is making no attempt to walk.
- B. She seems distressed with new adults.
- C. She does not respond to her own name.
- D. She only babbles "mama" and "dada."
Correct Answer: C
Rationale: By 9 months, children should be babbling simple words and crawling, and they should recognize and respond to their own name. They may begin attempting to walk or may just be starting to attempt to pull themselves up to stand. Strangers often produce fear or anxiety in infants this age.
When caring for pediatric clients, the nurse should pay special attention to the psychosocial development stages credited to ?
- A. Robert Peck
- B. Erik Erikson
- C. Sigmund Freud
- D. Jean Piaget
Correct Answer: B
Rationale: Erik Erikson is credited with the psychosocial development theory and eight stages. The nurse should take these stages into account when caring for pediatric clients to assess their development. Jean Piaget is responsible for cognitive development. Sigmund Freud is responsible for psychosexual development. Robert Peck is responsible for aging theory.
The nurse is assessing the 13-year-old who has been taking somatropin recombinant. Which findings should the nurse report to an HCP?
- A. Erythematous palmar rash
- B. Blood pressure of 122/74 mm Hg
- C. Random blood glucose of 158 mg/dL
- D. X-ray report noting epiphyseal closure
Correct Answer: D
Rationale: A: Erythematous palmar rash is not associated with the use of GH. B: BP of 122/74 in a 13-year-old is considered normal. C: Although GH use may be associated with blood glucose changes, a random blood glucose of 158 mg/dL is normal. D: Somatropin (Genotropin) recombinant is an injectable GH indicated for children with a deficiency of the hormone. It cannot be given once the epiphyses have closed. The nurse should notify the HCP.