Nokea
A client with an ileus is placed on intestinal tube suction. Which of the following electrolytes is lost with intestinal suction?
- A. calcium
- B. magnesium
- C. potassium
- D. sodium chloride
Correct Answer: D
Rationale: The correct answer is sodium chloride. Duodenal intestinal fluid is rich in potassium (K+), sodium (Na+), and bicarbonate. When suctioning is used to remove excess fluids due to ileus, it results in the loss of sodium chloride (NaCl) leading to decreased sodium (Na+) levels. Choices A, B, and C are incorrect because calcium, magnesium, and potassium are not typically lost in significant amounts through intestinal tube suction in the context of treating ileus.
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A nurse is preparing to assist the healthcare provider in performing an internal gynecological examination of a client. In which position does the nurse place the client for this examination?
- A. Prone
- B. Left side-lying
- C. Sims
- D. Lithotomy
Correct Answer: D
Rationale: An internal gynecological examination is performed with the client in the lithotomy position. In this position, the client is supine, with the feet in stirrups, the knees apart, and the buttocks at the end of the examining table. The client is draped so that only the vulva is exposed. The lithotomy position provides optimal access for the healthcare provider to perform the examination effectively. The prone position refers to lying on the stomach, which is not suitable for a gynecological exam. The Sims position is a left side-lying position primarily used for administering enemas, not for gynecological examinations.
When teaching a woman about possible side effects of hormone replacement therapy, the nurse should include information about all of the following except:
- A. Hypoglycemia in diabetic women.
- B. The possible return of monthly menses when taking combination hormones.
- C. Increased risk of gallbladder disease.
- D. Increased risk of breast, cervical, and ovarian cancer with long-term use.
Correct Answer: A
Rationale: The correct answer is 'Hypoglycemia in diabetic women.' When educating a woman about hormone replacement therapy, it is important to discuss the possible side effects. It is true that monthly menses might return when taking combination hormones, as the progestin can cause this. Additionally, there is an increased risk of gallbladder disease associated with hormone replacement therapy. Furthermore, long-term use of hormone replacement therapy is linked to an increased risk of breast, cervical, and ovarian cancer. However, hypoglycemia is not a common side effect of hormone replacement therapy, especially in diabetic women. In fact, estrogen can have a positive impact on glucose control in some cases, so hypoglycemia would not be a typical concern.
An LPN is tasked with checking the narcotic count on a medical-surgical unit. Which statement by the LPN requires further investigation?
- A. "I need a witness when I waste the leftover narcotics in the client's PCA pump."?
- B. "I am going to check the facility's policy for how to dispose of this controlled substance."?
- C. "I left the narcotics box unlocked after confirming the beginning of shift count was correct."?
- D. "The end of shift narcotics count is incorrect and needs to be reported."?
Correct Answer: C
Rationale: The LPN's statement about leaving the narcotics box unlocked after confirming the beginning of shift count was correct requires further investigation. Narcotics should be locked and kept in a secure place during the shift to prevent unauthorized access and ensure patient safety. This statement raises concerns about medication security, which is critical in preventing diversion and ensuring patient safety. The other statements demonstrate appropriate actions: A) The LPN acknowledges the need for a witness when wasting leftover narcotics, ensuring proper documentation and accountability during medication waste. B) Checking the facility's policy for proper disposal of controlled substances shows awareness of regulatory compliance regarding controlled substances. D) Recognizing an incorrect end-of-shift narcotics count and planning to report it reflects the LPN's responsibility in maintaining accurate records and addressing discrepancies, which is essential for medication safety and accountability.
Which of the following statements, if made by the parents of a newborn, does not indicate a need for further teaching about cord care?
- A. "I should not put alcohol on my baby's cord 3-4 times a day."?
- B. "I should not put the baby's diaper on so that it covers the cord."?
- C. "I should call the physician if the cord becomes dark."?
- D. "I should wash my hands before and after I take care of the cord."?
Correct Answer: B
Rationale: Parents should be taught not to cover the cord with a diaper to allow for air exposure and drying, preventing infection. The statement 'I should put alcohol on my baby's cord 3-4 times a day' indicates a need for further teaching as current recommendations do not include using alcohol on the cord, which can interfere with natural healing. While it is normal for the cord to turn dark as it dries, so the statement 'I should call the physician if the cord becomes dark' is accurate, it is not the best answer for this question. Washing hands before and after caring for the cord is important to prevent the transfer of pathogens, so this statement does not require further teaching.
When assisting the physician in performing transillumination of a client's scrotum, how should the nurse prepare for this procedure?
- A. Obtaining a flashlight and darkening the room
- B. Instructing the client to drink three glasses of water
- C. Instructing the client to take several deep breaths and bear down
- D. Telling the client that the procedure is very uncomfortable but that the discomfort will only last for a few moments
Correct Answer: A
Rationale: When preparing for transillumination of the scrotum, the nurse should obtain a flashlight and darken the room. This is done to allow the strong flashlight to be shined from behind the scrotal contents. Normal scrotal contents do not appear on transillumination. Instructing the client to drink fluids or to take deep breaths and bear down is not part of the preparation for this procedure. Additionally, it is not necessary to inform the client that the procedure is uncomfortable as transillumination is a painless procedure.