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A client with a reactive depression has the greaTest chance of success in activities that require psychic and physical energy if the nurse schedules activities in the
- A. morning hours.
- B. middle of the day.
- C. afternoon hours.
- D. evening hours.
Correct Answer: A
Rationale: client with reactive depression has the highest level of physical and psychic energy in the morning
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The nurse is caring for a client with a history of bipolar disorder who is receiving lithium 300 mg PO tid. Which of the following laboratory results would be of GREATest concern to the nurse?
- A. Lithium level of 2.0 mEq/L.
- B. Sodium 140 mEq/L.
- C. Potassium 4.0 mEq/L.
- D. Creatinine 1.0 mg/dL.
Correct Answer: A
Rationale: A lithium level of 2.0 mEq/L is toxic (therapeutic range 0.6–1.2 mEq/L), risking seizures or coma, requiring immediate intervention. Options B, C, and D are normal: sodium 140 mEq/L, potassium 4.0 mEq/L, and creatinine 1.0 mg/dL do not indicate complications.
The LPN/LVN is caring for an adult who has pneumonia. The nurse should instruct the nursing assistant to report which information immediately?
- A. Restlessness
- B. Pink-colored skin
- C. Nonproductive cough
- D. Dry mouth
Correct Answer: A
Rationale: Restlessness may indicate hypoxia in pneumonia, a critical symptom requiring immediate reporting to assess oxygenation status.
The nurse is assigned to care for a client who has a leaking intracranial aneurysm. To minimize the risk of rebleeding, the nurse should plan to
- A. restrict visitors to immediate family
- B. avoid arousal of the client except for family visits
- C. keep client's hips flexed at no less than 90 degrees
- D. apply a warming blanket for temperatures of 98 degrees Fahrenheit or less
Correct Answer: A
Rationale: restrict visitors to immediate family. Maintaining a quiet environment will assist in minimizing cerebral rebleeding. When family visit, the client should not be disturbed. If the client is awake, topics of a general nature are better choices for discussion than topics that result in emotional or physiological stimulation.
A baby girl weighing 7 lb 4 oz with Apgar scores of 7 and 8 at one and five minutes is admitted to the nursery. Her mother is a type I diabetic.
The nurse knows the infant is at GREATest risk for developing
- A. hypovolemia.
- B. hypoglycemia.
- C. hyperglycemia.
- D. cold stress.
Correct Answer: B
Rationale: Strategy: Determine the cause of each answer choice. (1) no change in blood volume for infant of diabetic mother (2) correct-fetus produces increased insulin to match mother's increased glucose level during pregnancy, infant continues to have high insulin output after birth, resulting in hypoglycemia (3) infant would be at risk of hypoglycemia due to increased insulin production (4) thermal receptors in skin are stimulated due to cold environment, increases metabolic rate, infant needs to maintain normal body temperature while producing minimal amount of heat generated from metabolic processes, not expected with diabetic mother
The newborn infant of an HIV-positive mother is admitted to the nursery.
- A. What should the nurse include in the plan of care for a newborn of an HIV-positive mother?
- B. Standard precautions.
- C. Test ing for HIV.
- D. Transfer to an acute care nursery facility.
- E. Request AZT from the pharmacy.
Correct Answer: A
Rationale: Standard precautions are the immediate priority to protect staff and others from potential HIV transmission. HIV Test ing and AZT may be considered later, and transfer is unnecessary without clinical indication.