Nokea
A client is taking tranylcypromine (Parnate) and has received dietary instruction. Which of the following food selections would be contraindicated for this client?
- A. Fresh juice, carrots, vanilla pudding
- B. Apple juice, ham salad, fresh pineapple
- C. Hamburger, fries, strawberry shake
- D. Red wine, fava beans, aged cheese
Correct Answer: D
Rationale: Red wine, fava beans, and aged cheese contain tyramine and other vasopressors that can interact with MAOIs, potentially causing malignant hypertension.
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Which of these tests would the nurse expect to monitor for the evaluation of clients aged 18 and older with poor glycemic control?
- A. A glycosylated hemoglobin (A1c) should be performed during an initial assessment and during follow-up assessment, which should occur in longer than 3-month intervals
- B. A glycosylated hemoglobin is to be obtained at least two years
- C. A fasting glucose and a glycosylated hemoglobin is to be obtained at 3 months intervals after the initial assessment
- D. A glucose tolerance test, a fasting glucose and a glycosylated hemoglobin should be obtained at 6-month intervals after the initial assessment
Correct Answer: A
Rationale: The American Diabetes Association (ADA) recommends obtaining a glycosylated hemoglobin during an initial assessment and then routinely as part of continuing care for clients with poor glycemic control.
The nurse is caring for assigned clients. Which of the following clients should the nurse check first?
- A. client who had a cholecystectomy and is reporting incisional pain as 5 on a scale of 1-10
- B. client who had an open reduction of the right femur and is reporting nausea
- C. client with type 1 diabetes mellitus and a blood glucose level of 55 mg/dL (3.1 mmol/L)
- D. client with type 2 diabetes mellitus and a blood glucose level of 250 mg/dL (13.9 mmol/L)
Correct Answer: C
Rationale: A blood glucose level of 55 mg/dL indicates severe hypoglycemia, a life-threatening condition requiring immediate intervention to prevent seizures or coma.
Which of the following conditions is most likely related to the development of renal calculi?
- A. Gout
- B. Pancreatitis
- C. Fractured femur
- D. Disc disease
Correct Answer: A
Rationale: Gout increases uric acid levels, which can lead to uric acid kidney stones, a common type of renal calculi.
A 9-year-old with type 1 diabetes takes insulin glargine and NPH regularly. While at school, the client becomes shaky, diaphoretic, and pale. What is the most appropriate action by the nurse?
- A. Administer scheduled dose of NPH insulin
- B. Give emergency glucagon IM injection
- C. Give peanut butter and crackers
- D. Provide 4 oz (120 mL) of a regular soft drink
Correct Answer: D
Rationale: Shakiness, diaphoresis, and pallor indicate hypoglycemia. Providing 15 grams of fast-acting carbohydrates, such as 4 oz of a regular soft drink, is the first-line treatment.
The nurse has attended a staff education program about needlestick injuries. Which of the following statements by the nurse would require follow-up?
- A. Needlestick injuries should be reported to the employee health clinic.
- B. Needlestick injuries can be prevented by recapping needles after use.
- C. Postexposure prophylaxis may be prescribed after a needlestick injury occurs.
- D. Soap and water should be used to wash the affected area after a needlestick injury occurs.
Correct Answer: B
Rationale: Recapping needles increases the risk of injury and is not recommended. Needles should be disposed of in sharps containers immediately after use.