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A client on hemodialysis is complaining of muscle weakness and numbness in his legs. His lab results are: Na 136 mEq/L, K 5.9 mEq/L, Cl 100 mEq/L, ca 8.5 mg/dl. Which electrolyte imbalance is the client suffering from?
- A. Hyperkalemia
- B. Hypocalcemia
- C. Hypernatremia
- D. Hypochloremia
Correct Answer: A
Rationale: The client is experiencing muscle weakness and numbness in his legs, which are symptoms commonly associated with hyperkalemia (high potassium levels). The potassium level of 5.9 mEq/L is above the normal range (3.5-5.0 mEq/L), indicating hyperkalemia. Hyperkalemia can lead to muscle weakness, numbness, and potentially more severe complications like cardiac arrhythmias.
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is type of hydrocephalus which there no obstructive to pass CSF but malformation of arachnoid villi :
- A. non communicating hydrocephalus
- B. communicating hydrocephalus
- C. obstructive hydrocephalus
- D. non of the above
Correct Answer: B
Rationale: Communicating hydrocephalus is a type of hydrocephalus where there is no obstruction to the passage of cerebrospinal fluid (CSF), but rather a malfunction or malformation of the arachnoid villi, which are responsible for the reabsorption of CSF. In communicating hydrocephalus, the flow of CSF within the ventricular system is disrupted, leading to an accumulation of fluid and resulting in increased intracranial pressure.
The nurse observes flaring of nares in a newborn. This should be interpreted as:
- A. nasal occlusion.
- B. sign of respiratory distress.
- C. common response to sneezing.
- D. snuffles of congenital syphilis.
Correct Answer: B
Rationale: Flaring of nares in a newborn is typically interpreted as a sign of respiratory distress. When a baby is having trouble breathing or is not getting enough oxygen, the body compensates by increasing the size of the nasal passages to allow for easier airflow. This response helps the baby to breathe more effectively during times of respiratory distress. It is important for healthcare providers to recognize this sign as it may indicate the need for prompt intervention and support to help the baby breathe more comfortably.
Which is descriptive of attention deficit hyperactivity disorder (ADHD)?
- A. Manifestations exhibited are so bizarre that the diagnosis is fairly easy.
- B. Manifestations affect every aspect of the child's life but are most obvious in the classroom.
- C. Learning disabilities associated with ADHD eventually disappear when adulthood is reached.
- D. Diagnosis of ADHD requires that all manifestations of the disorder be present.
Correct Answer: B
Rationale: Option B is descriptive of attention deficit hyperactivity disorder (ADHD). Manifestations of ADHD can significantly impact the child's life, but are most noticeable in the classroom setting. Children with ADHD may struggle with paying attention, staying organized, controlling impulsive behavior, and following instructions in the school environment. While symptoms can also affect other areas of life, such as social interactions and familial relationships, they are typically most prominently displayed in the structured school setting, making it easier to recognize and diagnose the disorder.
A client tells the nurse that she has been working hard for the last 3 months to control her type 2 diabetes mellitus with diet and exercise. To determine the effectiveness of the client's efforts, the nurse should check:
- A. Urine glucose level
- B. Serum fructosamine level
- C. Fasting blood glucose level
- D. Glycosylated hemoglobin level
Correct Answer: D
Rationale: Checking the glycosylated hemoglobin (HbA1c) level is the most appropriate way to determine the effectiveness of the client's efforts to control type 2 diabetes mellitus over the past few months. HbA1c provides an average of the blood glucose levels over the past 2-3 months, reflecting how well the client has been managing their diabetes. This test is not affected by recent food intake or physical activity, making it a reliable indicator of long-term glucose control. Unlike fasting blood glucose levels or urine glucose levels, which can fluctuate throughout the day, HbA1c gives a more comprehensive view of glucose control and helps guide treatment decisions.
After the surgical incision has been clised and the anesthesia has wear-off, the patient is extubated and transferred to the postanesthesia care unit (PACU). Who is responsible for transferring the patient?
- A. Circulating nurse
- B. scrub nurse
- C. surgeon
- D. anesthesiologist
Correct Answer: D
Rationale: The anesthesiologist is responsible for transferring the patient to the postanesthesia care unit (PACU) after the surgical incision has been closed and the anesthesia has worn off. The anesthesiologist ensures that the patient is stable and ready for transfer, including assessing vital signs and overall condition. Due to their specialized training in anesthesia and perioperative care, the anesthesiologist is best equipped to manage the transition of care from the operating room to the PACU, where the patient will continue to be monitored closely during the immediate postoperative period.