Nokea
A 6-year-old child is seen in the physician's office. His mother tells you that for the last few weeks, the child has been urinating frequently, drinking and eating a lot. The nurse determines that the urine specific gravity is 1.004. The child is afebrile. What tests does the nurse expect to be ordered for this client at this time?
- A. CBC with differential
- B. Urine and finger stick glucose tests
- C. Intravenous pyelogram.
- D. Urine for culture and sensitivity
Correct Answer: B
Rationale: Polyuria, polydipsia, polyphagia, and low urine specific gravity (1.004) suggest diabetes mellitus; urine and finger stick glucose tests confirm hyperglycemia. CBC, IVP, or culture are less relevant.
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The nurse notes that the client has a pulse deficit. What is the most appropriate action for the nurse?
- A. Document this as a normal finding.
- B. Instruct the client to report to the clinic for a weekly reevaluation.
- C. Report this finding immediately to the client's physician.
- D. Teach the client how to monitor pulse at home.
Correct Answer: C
Rationale: A pulse deficit indicates irregular heartbeats, requiring immediate physician notification to assess for arrhythmias.
The nurse is teaching a client with a new diagnosis of gout about colchicine. Which of the following instructions should the nurse include?
- A. Take the medication with grapefruit juice.
- B. Report any diarrhea.
- C. Stop the medication if gout attacks cease.
- D. Avoid regular joint exams.
Correct Answer: B
Rationale: Diarrhea is a serious colchicine side effect, indicating potential toxicity. Options A, C, and D are incorrect.
The nurse is performing discharge teaching for a client with Addison’s disease.
- A. What is the most important instruction for a client with Addison’s disease?
- B. Signs and symptoms of infection.
- C. Fluid and electrolyte balance.
- D. Seizure precautions.
- E. Steroid replacement.
Correct Answer: D
Rationale: Steroid replacement is critical for Addison’s disease to manage adrenal insufficiency and prevent life-threatening crises. Infection, fluid balance, and seizures are secondary concerns compared to ensuring steroid therapy adherence.
The nurse is caring for an adult who had a cervical laminectomy this morning. After an uneventful stay in the postanesthesia care unit, the client is returned to the nursing care unit. How should the client be positioned immediately upon return?
- A. Supine
- B. Prone
- C. Semi-reclining
- D. Side-lying
Correct Answer: C
Rationale: Semi-reclining reduces neck strain and swelling post-cervical laminectomy, promoting comfort and healing. Supine or prone may increase pressure, and side-lying is less optimal.
An eight-month-old infant.
The nurse should look for which of the following in assessing pain in an eight-month-old infant?
- A. Decreased pulse rate.
- B. Increased fluid intake.
- C. Decreased respiratory rate.
- D. Rubbing a body part and crying.
Correct Answer: D
Rationale: Strategy: Think about each assessment. (1) pulse rate would increase (2) nonspecific regarding pain (3) does not reflect pain (4) correct-since an infant cannot talk, nurse needs to be aware of nonverbal signs of pain, such as rubbing the ear because of an earache