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A client with diabetes experiences Somogyi's effect. To prevent this complication, the nurse should instruct the client to:
- A. Take insulin at 2:00 PM each day
- B. Engage in physical activity daily
- C. Increase the dose of regular insulin
- D. Eat a protein and carbohydrate snack at bedtime
Correct Answer: D
Rationale: Somogyi effect, also known as rebound hyperglycemia, occurs as a response to nighttime hypoglycemia. Eating a protein and carbohydrate snack at bedtime can help prevent this by stabilizing blood sugar levels throughout the night. Instructing the client to take insulin at 2:00 PM each day (Choice A) may not directly address the nighttime hypoglycemia concern. Engaging in physical activity daily (Choice B) is generally beneficial for diabetes management but may not specifically prevent Somogyi's effect. Increasing the dose of regular insulin (Choice C) without addressing the nighttime hypoglycemia issue can exacerbate the problem.
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A nurse in a long-term care facility is caring for a client who reports the AP repositioned him in bed using excessive force. Which of the following actions should the nurse take?
- A. Document in the client's chart that an incident report has been filed.
- B. Contact the nurse manager.
- C. Reassure the client that the staff is well trained.
- D. Call risk management to interview the client.
Correct Answer: B
Rationale: The correct action for the nurse to take in this situation is to contact the nurse manager. By doing so, the nurse can escalate the issue appropriately, ensuring that the incident is addressed and necessary actions are taken. Documenting in the client's chart that an incident report has been filed (Choice A) may be necessary but should not be the first step. Reassuring the client that the staff is well trained (Choice C) does not address the client's concern and the need for intervention. Calling risk management to interview the client (Choice D) may be premature at this stage and should be handled by the nurse manager first.
What are the six levels of consciousness from the most to the least responsive level of consciousness? Number all six using 1 as the most conscious and 6 as the least conscious.
- A. Obtunded, Confused, Lethargic, Comatose, Stuporous, Alert
- B. Confused, Lethargic, Obtunded, Stuporous, Comatose, Alert
- C. Lethargic, Obtunded, Confused, Stuporous, Comatose, Alert
- D. Alert, Confused, Lethargic, Obtunded, Stuporous, Comatose
Correct Answer: D
Rationale: The correct order of the six levels of consciousness from most to least responsive is Alert, Confused, Lethargic, Obtunded, Stuporous, Comatose. Choice A is incorrect because it starts with Obtunded, which is less responsive than Alert. Choice B is incorrect as it doesn't follow the correct order. Choice C is incorrect as Lethargic is more responsive than Obtunded. Therefore, the correct answer is D.
Which preventive measure can be employed to decrease the risk of compartment syndrome?
- A. The administration of a potassium-sparing diuretic for heart failure
- B. A bivalve cast for a skeletal fracture
- C. A cerebral diuretic to decrease intracranial pressure after a head injury
- D. A chest tube to restore normal intrathoracic pressure after a pneumothorax
Correct Answer: B
Rationale: The correct answer is B. A bivalve cast can help decrease the risk of compartment syndrome by providing space for swelling, thus preventing the build-up of pressure within the muscles. Choices A, C, and D are incorrect because they are not directly related to preventing compartment syndrome. Choice A is more focused on managing heart failure, choice C on reducing intracranial pressure, and choice D on restoring intrathoracic pressure after a pneumothorax, which are not relevant to preventing compartment syndrome.
A nurse is preparing to discharge a client who has end-stage heart failure. The client's partner tells the nurse she can no longer handle caring for the client. Which of the following actions should the nurse take?
- A. Request another family member to assist the client's partner with care
- B. Recommend the partner to place the client in a long-term care facility
- C. Contact the case manager to discuss discharge options
- D. Ask the provider to delay the client's discharge home for a few more days
Correct Answer: C
Rationale: The nurse should contact the case manager to discuss discharge options and support the client's partner. This action is appropriate as it involves seeking professional guidance and support for the client's partner who is struggling to care for the client. Option A is not the best choice as it solely focuses on involving another family member without addressing the partner's concerns directly. Option B is premature as recommending long-term care should be a well-considered decision involving multiple healthcare professionals. Option D delays the inevitable without providing a solution to the partner's current challenges.
Which of the following strategies can help reduce healthcare-associated infections?
- A. Using outdated medical equipment
- B. Implementing strict hygiene protocols
- C. Increasing patient wait times
- D. Reducing nursing staff
Correct Answer: B
Rationale: Correct Answer: Implementing strict hygiene protocols can help reduce healthcare-associated infections. By maintaining high standards of hygiene, such as proper handwashing, sterilization of equipment, and cleanliness of the environment, the spread of infections can be minimized. Choices A, C, and D are incorrect. Using outdated medical equipment can increase the risk of infections due to lack of proper maintenance and sterilization. Increasing patient wait times may lead to frustration but does not directly impact infection rates. Reducing nursing staff can compromise patient care and monitoring but is not specifically related to reducing healthcare-associated infections.