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A client with a history of type 2 diabetes is prescribed glipizide (Glucotrol). The nurse should instruct the client to:
- A. Take the medication 30 minutes before meals.
- B. Avoid alcohol consumption.
- C. Take the medication at bedtime.
- D. Stop the medication if blood glucose normalizes.
Correct Answer: A, B
Rationale: Glipizide should be taken 30 minutes before meals to optimize glucose control, and alcohol should be avoided to prevent hypoglycemia.
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When developing the plan of care for a 14-year-old boy with a nursing diagnosis of Deficient diversional activity related to immobility, which of the following activities is most appropriate?
- A. Playing a card game with a boy the same age.
- B. Putting together a puzzle with his mother.
- C. Playing video games with a 9-year-old.
- D. Watching a movie with his younger brother.
Correct Answer: A
Rationale: A peer-based activity like a card game promotes social interaction and engagement, suitable for a 14-year-old's developmental needs.
The nurse is planning care for a client who chews the fingers constantly. Before applying mitten restraints, the nurse could try which of the following interventions? Select all that apply.
- A. Ask the client to rub lotion over the hands every day after bathing.
- B. Encourage physical activity, such as ambulation.
- C. Provide frequent contacts for communication and socialization.
- D. Provide family education.
- E. Encourage involvement of family and friends.
Correct Answer: A,B,C,E
Rationale: Non-restrictive interventions like applying lotion, encouraging physical activity, providing social interaction, and involving family can address the behavior's underlying causes, such as anxiety or sensory needs, while promoting client autonomy and engagement.
A client with a history of rheumatoid arthritis is prescribed etanercept (Enbrel). The nurse should monitor the client for which of the following adverse effects?
- A. Increased infection risk.
- B. Hyperglycemia.
- C. Hypertension.
- D. Weight loss.
Correct Answer: A
Rationale: Etanercept, a biologic, increases infection risk due to immunosuppression.
A client with a history of chronic kidney disease is prescribed calcitriol (Rocaltrol). The nurse should explain that this medication works by:
- A. Reducing blood pressure.
- B. Increasing calcium absorption.
- C. Decreasing phosphate levels.
- D. Increasing urine output.
Correct Answer: B
Rationale: Calcitriol, a vitamin D analog, increases calcium absorption in chronic kidney disease to correct hypocalcemia.
The registered nurse is observing a new nurse auscultate the breath sounds of a client. Which action by the new nurse should lead the registered nurse to determine that further teaching is needed?
- A. Uses the bell of the stethoscope
- B. Asks the client to sit straight up
- C. Places the stethoscope directly on the client's skin
- D. Encourages the client to breathe slowly and deeply through the mouth
Correct Answer: A
Rationale: The bell of the stethoscope is not used to auscultate breath sounds. The client ideally should sit up and breathe slowly and deeply through the mouth. The diaphragm of the stethoscope, which is warmed before use, is placed directly on the client's skin, not over a gown or clothing.