Nokea
A 32-year-old man comes to the clinic for a glycosylated hemoglobin assay (HbA1c). The result is 6%. The nurse should
- A. document the findings in the chart.
- B. call the physician about orders to adjust the insulin dosage.
- C. give him 15 g of carbohydrates.
- D. ask him to list the foods he has eaten in the last 24 hours.
Correct Answer: A
Rationale: An HbA1c of 6% indicates good diabetes control (normal 4–6%). Documenting is appropriate as no action is needed. Options B, C, and D are unnecessary.
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The nurse is working in a surgeon's office and talking with a client who is scheduled for surgery in two weeks. The nurse asks about medications and supplements the client may be taking. What medication(s) the client reports would be of most concern to the nurse? Select all that apply.
- A. Acetaminophen
- B. Ibuprofen
- C. Vitamin C
- D. Vitamin E
- E. Ginseng
- F. Vitamin B complex
Correct Answer: B,D,E
Rationale: Ibuprofen, Vitamin E, and ginseng increase bleeding risk, posing concerns for surgical hemostasis.
A 5-year-old child has been treated for sickle cell crisis. The parent asks the nurse if there is anything that can be done to prevent future crises. What should be included in the nurse's response?
- A. Sickle crisis is hard to predict and not usually preventable.
- B. Keeping the child from getting chilled may prevent a crisis.
- C. Fevers, vomiting, and diarrhea should be reported to the physician immediately.
- D. Giving the child aspirin on a daily basis lessens the frequency of crises.
Correct Answer: C
Rationale: Fevers, vomiting, and diarrhea can trigger sickle cell crisis by causing dehydration or infection, so prompt reporting allows early intervention to prevent crises.
The nurse is planning care for a client who had surgery for an ileal conduit two days ago. It is MOST important for the nurse to take which of the following actions?
- A. Remove the appliance regularly and clean the skin with antiseptic solution.
- B. Apply a close-fitting drainage bag to the stoma.
- C. Massage the skin around the stoma with an emollient.
- D. Expose the area around the stoma to air twice a day.
Correct Answer: B
Rationale: A close-fitting drainage bag prevents urine leakage, protecting skin integrity post-ileal conduit. Options A, C, and D risk skin irritation or bag adhesion issues.
The nurse is caring for a client with a long leg cast on his right leg. The nurse notes that the right foot is pale and cool to the touch, and the client continues to complain of pain even though an analgesic was administered 45 minutes ago. What is the FIRST action the nurse should take?
- A. Apply a heating pad to the client's right toes.
- B. Repeat the dose of the analgesic stat.
- C. Remove the cast immediately.
- D. Notify the physician immediately.
Correct Answer: D
Rationale: Pale, cool skin and persistent pain suggest compartment syndrome, requiring immediate physician notification. Options A, B, and C are unsafe.
Hospital staff requests that the parents with a Greek heritage of a hospitalized infant remove the amulet from around the child's neck. The parents refuse. The nurse understands that the parents may be concerned about
- A. Mental development delays
- B. Evil eye or envy of others
- C. Fright from spiritual beings
- D. Balance in body systems
Correct Answer: B
Rationale: Evil eye or envy of others. In Greek culture, amulets protect against 'matiasma' or the evil eye, especially for children.