Nokea
A client, age 21, is admitted with bacterial meningitis. Which hospital room would be the appropriate choice for this client?
- A. A private room down the hall from the nurses' station
- B. An isolation room close to the nurses' station
- C. A semiprivate room with a 32-year-old client who has viral meningitis
- D. A two-bed room with a client who previously had bacterial meningitis
Correct Answer: B
Rationale: A client with bacterial meningitis should be kept in isolation for at least 24 hours after admission and, during the initial acute phase, should be as close to the nurses' station as possible to allow maximal observation. Placing the client in a room with a client who has viral meningitis may cause harm to both clients because the organisms causing viral and bacterial meningitis differ; either client may contract the other's disease. Immunity to bacterial meningitis can't be acquired; therefore, a client who previously had bacterial meningitis shouldn't be put at risk by rooming with a client who has just been diagnosed with this disease.
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A patient who sustained massive internal injuries in a car crash becomes hypotensive and develops acute renal failure.
Which acid-base imbalance is he most likely to experience?
- A. Respiratory acidosis
- B. Metabolic acidosis
- C. Respiratory alkalosis
- D. Metabolic alkalosis
Correct Answer: B
Rationale: Renal failure causes metabolic acidosis due to impaired acid excretion.
Francis is a 48-year-old female with elevated blood sugar level.
An immediate danger to confront Francis secondary to her elevated blood sugar level is
- A. albumin is negative.
- B. dehydration and impending shock.
- C. hyperglycemia.
- D. renal failure.
Correct Answer: B
Rationale: Glucose has an osmotic diuretic effect causing polyuria, which can lead to dehydration and impending shock if not addressed promptly.
Which interventions are appropriate when caring for a client with acute thrombophlebitis?
- A. Apply cool soaks and keep the client's leg lower than the level of the heart
- B. Increase the client's activity level and encourage leg exercises
- C. Apply cool soaks and administer nitroglycerin
- D. Apply warm soaks and elevate the client's legs higher than the level of the heart
Correct Answer: D
Rationale: To help treat thrombophlebitis, the nurse should prevent venostasis with measures such as applying warm soaks and elevating the client's legs. The client should remain on bed rest during the acute phase, after which the client may begin to walk while wearing antiembolism stockings. Treatment for thrombophlebitis may also include anticoagulants to prolong clotting time.
The nurse should explain to a client that tolbutamide (Orinase) is effective for diabetics who
- A. can no longer produce any insulin.
- B. produce minimal amounts of insulin.
- C. are unable to administer their injections.
- D. have a sustained decreased blood glucose.
Correct Answer: B
Rationale: Tolbutamide, an oral hypoglycemic, is effective for type 2 diabetes patients who produce minimal insulin, stimulating insulin release. Type 1 diabetics (A) produce no insulin, injection inability (C) is irrelevant, and low blood glucose (D) is not an indication for tolbutamide.
Classic symptoms of appendicitis:
Classic symptoms of appendicitis:
- A. Diffused abdominal pain occurs before nausea, fever.
- B. Pain in the right side of the abdomen, fever, elevated WBC.
- C. Pain and decreased sensation in the right leg.
- D. Distended abdomen, indigestion-like symptom.
Correct Answer: B
Rationale: Right lower quadrant pain, fever, and elevated WBC are classic appendicitis symptoms.