Nokea
A client has implemented dietary and other lifestyle changes to manage hypertension. The nurse determines that the client has been most successful when the client has which follow-up blood pressure reading?
- A. 164/90 mm Hg
- B. 156/89 mm Hg
- C. 140/94 mm Hg
- D. 128/84 mm Hg
Correct Answer: D
Rationale: Normal blood pressure readings are less than 120/80 mm Hg. A blood pressure reading between 120/80 mm Hg and 139/89 mm Hg is considered to be a prehypertensive state. From the readings provided in the options, the correct option identifies the most successful outcome, although the reading indicates a prehypertensive state.
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A client with a history of tuberculosis is prescribed isoniazid. Which supplement should the nurse administer concurrently?
- A. Vitamin C
- B. Vitamin B6
- C. Vitamin D
- D. Vitamin K
Correct Answer: B
Rationale: Isoniazid can cause peripheral neuropathy due to vitamin B6 deficiency, so pyridoxine (vitamin B6) is administered to prevent this side effect.
A client with a history of type 1 diabetes mellitus is prescribed insulin detemir (Levemir). The nurse should explain that this insulin:
- A. Is taken as needed for high blood sugar.
- B. Provides a steady basal insulin level.
- C. Should be mixed with short-acting insulin.
- D. Is administered immediately before meals.
Correct Answer: B
Rationale: Insulin detemir provides a steady basal insulin level over 24 hours, used for long-term glucose control.
Select the age group that is accurately paired with the normal and recommended hours of sleep each day.
- A. The neonate: 10 to 15 hours a day
- B. The toddler: 11 to 14 hours a day
- C. The preschool child: 12 to 15 hours a day
- D. The school age child: Less than 8 hours a day
Correct Answer: B
Rationale: Toddlers (1-2 years) typically require 11-14 hours of sleep per day, including naps, which is the correct pairing.
Which of the following is considered an internal disaster?
- A. A tornado that has touched down on the healthcare facility
- B. A severe cyclone that has destroyed nearby homes
- C. A massive train accident that brings victims to your facility
- D. An act of bioterrorism in a nearby factory
Correct Answer: A
Rationale: An internal disaster is an event within the healthcare facility, such as a tornado directly affecting it, requiring internal emergency protocols.
While assessing a term neonate on a home visit to a primiparous client 2 weeks after a vaginal delivery, the nurse observes that the neonate is slightly jaundiced and the stool is a pale, light color. The nurse notifies the physician because these findings indicate which of the following?
- A. Biliary atresia.
- B. Rh isoimmunization.
- C. ABO incompatibility.
- D. Esophageal varices.
Correct Answer: A
Rationale: Pale stools and jaundice in a neonate suggest biliary atresia, a condition requiring urgent evaluation.