Nokea
A 9-year-old female client was recently diagnosed with diabetes mellitus. Which symptom will her parents most likely report?
- A. Refuses to eat her favorite meals at home.
- B. Drinks more soft drinks than previously.
- C. Voids only one or two times per day.
- D. Gained 10 pounds within one month.
Correct Answer: B
Rationale: The correct answer is B because increased thirst and drinking more fluids than usual is a common symptom of diabetes mellitus due to high blood sugar levels causing dehydration. Refusing to eat favorite meals (choice A) is not a typical symptom. Voids only one or two times per day (choice C) is more related to urinary issues than diabetes. Gaining 10 pounds within one month (choice D) is not a specific symptom of diabetes and can be attributed to various factors.
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What action should the healthcare provider take to reduce the risk of vesicant extravasation in a client receiving intravenous chemotherapy?
- A. Administer an antiemetic before starting the chemotherapy.
- B. Instruct the client to drink plenty of fluids during the treatment.
- C. Keep the head of the bed elevated until the treatment is completed.
- D. Monitor the client's intravenous site hourly during the treatment.
Correct Answer: D
Rationale: The correct answer is D: Monitor the client's intravenous site hourly during the treatment. This is crucial to reduce the risk of vesicant extravasation, which can cause tissue damage if the chemotherapy leaks into the surrounding tissues. By monitoring the IV site hourly, the healthcare provider can detect any signs of infiltration or extravasation early and take necessary actions to prevent further harm.
A: Administering an antiemetic before starting chemotherapy is unrelated to preventing vesicant extravasation.
B: Instructing the client to drink plenty of fluids does not directly address the risk of vesicant extravasation.
C: Keeping the head of the bed elevated is not specific to preventing vesicant extravasation and may not effectively reduce the risk.
An elderly male client reports to the clinic nurse that he is experiencing increasing nocturia with difficulty initiating his urine stream. He reports a weak urine flow and frequent dribbling after voiding. Which nursing action should be implemented?
- A. Obtain a urine specimen for culture and sensitivity.
- B. Encourage the client to schedule a digital rectal exam.
- C. Advise the client to maintain a voiding diary for one week.
- D. Instruct the client in effective techniques for cleansing the glans penis.
Correct Answer: B
Rationale: The correct answer is B: Encourage the client to schedule a digital rectal exam. This option is correct because the client's symptoms of nocturia, weak urine flow, and difficulty initiating urine stream suggest potential prostate issues, such as benign prostatic hyperplasia (BPH). A digital rectal exam can help assess the size and condition of the prostate gland. It is an essential step in diagnosing BPH or other prostate conditions.
Other choices are incorrect because:
A: Obtaining a urine specimen for culture and sensitivity is not the priority in this case, as the client's symptoms are more indicative of a prostate issue rather than a urinary tract infection.
C: Maintaining a voiding diary may provide information on the frequency and volume of urine output, but it does not address the underlying cause of the client's symptoms.
D: Instructing the client in cleansing techniques for the glans penis is not relevant to the reported symptoms and does not address the potential prostate issue.
What instruction should be provided to a client with a history of myocardial infarction (MI) who is prescribed nitroglycerin?
- A. Take nitroglycerin with food to avoid stomach upset.
- B. Store nitroglycerin tablets in a dark, glass container.
- C. Swallow nitroglycerin tablets whole without chewing.
- D. Discontinue the medication if a headache occurs.
Correct Answer: B
Rationale: The correct answer is B because nitroglycerin tablets should be stored in a dark, glass container to protect them from light and moisture, which could decrease their effectiveness. Storing them in any other container could lead to degradation of the medication.
Choice A is incorrect because nitroglycerin should be taken sublingually, not with food. Choice C is incorrect because nitroglycerin should be placed under the tongue to be absorbed quickly, not swallowed whole. Choice D is incorrect because experiencing a headache is a common side effect of nitroglycerin and does not indicate that the medication should be discontinued.
A client with chronic kidney disease (CKD) has an arteriovenous (AV) fistula for hemodialysis. Which finding should the nurse report to the healthcare provider immediately?
- A. No bruit or thrill over the AV fistula.
- B. Redness at the site of the AV fistula.
- C. Client's complaint of pain at the AV fistula site.
- D. Swelling of the hand on the side of the AV fistula.
Correct Answer: A
Rationale: The correct answer is A: No bruit or thrill over the AV fistula. A bruit and thrill indicate proper blood flow through the AV fistula, essential for successful hemodialysis. Absence of these sounds can indicate AV fistula malfunction, leading to inadequate dialysis. Redness, pain, and swelling are common complications of AV fistula placement but do not require immediate reporting unless severe or accompanied by other symptoms like fever or pus drainage. Reporting the absence of a bruit or thrill promptly allows for timely intervention to prevent complications and ensure effective dialysis.
A client is admitted with suspected meningitis. Which assessment finding requires immediate intervention?
- A. Headache.
- B. Fever.
- C. Nuchal rigidity.
- D. Seizures.
Correct Answer: D
Rationale: The correct answer is D: Seizures. Seizures in a patient with suspected meningitis indicate increased intracranial pressure, which is a medical emergency requiring immediate intervention to prevent brain damage or herniation. Headache (A), fever (B), and nuchal rigidity (C) are common symptoms of meningitis but do not pose an immediate threat to life like seizures do. Addressing the seizures first is crucial to prevent further complications and ensure the patient's safety.