Nokea
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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During which stage of anesthesia is a patient most likely to experience involuntary motor activity?
- A. Stage I
- B. Stage II
- C. Stage III
- D. Stage VI
Correct Answer: B
Rationale: The correct answer is Stage II. During Stage II of anesthesia, a patient is most likely to experience involuntary motor activity. This stage is known as the excitement stage, where the patient may exhibit purposeful or involuntary movements.
Choice A (Stage I) is incorrect because Stage I is the induction phase where the patient is transitioning from consciousness to unconsciousness, and involuntary motor activity is less likely to occur.
Choice C (Stage III) is incorrect as it is the stage of surgical anesthesia characterized by muscle relaxation, and involuntary motor activity is less common during this stage.
Choice D (Stage VI) is incorrect as there is no Stage VI in the standard stages of anesthesia. Therefore, the most appropriate stage where involuntary motor activity is likely to occur is Stage II.
A client is in DKA, secondary to infection. As the condition progresses, which of the following symptoms might the nurse see?
- A. Kussmaul's respirations and a fruity odor on the breath
- B. Shallow respirations and severe abdominal pain
- C. Decreased respirations and increased urine output
- D. Cheyne-Stokes respirations and foul-smelling urine
Correct Answer: A
Rationale: In diabetic ketoacidosis (DKA), as the condition progresses, the body tries to compensate for the acidic environment by increasing the respiratory rate, leading to Kussmaul's respirations. The accumulation of ketones in the body causes a fruity odor on the breath. Option A is correct because Kussmaul's respirations and a fruity odor on the breath are classic signs of DKA. Option B is incorrect because shallow respirations are not typically seen in DKA, and severe abdominal pain is more commonly associated with conditions like pancreatitis. Option C is incorrect as decreased respirations are not a typical finding in DKA, and increased urine output is more commonly seen in conditions like diabetes insipidus. Option D is incorrect because Cheyne-Stokes respirations are not characteristic of DKA, and foul-smelling urine is not a prominent symptom in this condition.
Your 54-year-old male HIV-positive patient has just expired. How should you care for this deceased patient?
- A. Bathe the patient, but it is still necessary to use standard precautions because the patient is deceased.
- B. Place the patient in a negative pressure isolated area of the morgue.
- C. Double shroud the patient to prevent the spread of infection.
- D. Bathe the patient using the same standard precautions you used when he was alive.
Correct Answer: D
Rationale: Even after a patient has expired, standard precautions should be maintained to prevent the spread of infection. Bathing the deceased patient should be done using the same standard precautions followed when the patient was alive. This includes using personal protective equipment and following proper infection control procedures. Choices A, B, and C are incorrect because standard precautions must still be adhered to even after the patient has passed away to ensure safety and prevent the transmission of infections.
A nurse is caring for a client who reports acute pain but refuses IM medication. The nurse distracts the client and quickly administers the injection. This illustrates which of the following?
- A. Assault
- B. False imprisonment
- C. Battery
- D. Libel
Correct Answer: C
Rationale: The correct answer is C, 'Battery.' Administering the injection without the client's consent constitutes battery. Assault involves the threat of harm, not the actual act. False imprisonment is restraining a client against their will, which does not apply here. Libel refers to a false written statement, which is not relevant in this scenario.
Your patient has been diagnosed with giant cell arthritis. What medication will this patient most likely be given?
- A. High doses of aspirin
- B. High doses of prednisone
- C. Methotrexate
- D. Albuterol
Correct Answer: B
Rationale: High doses of prednisone are commonly prescribed for giant cell arthritis to reduce inflammation. Aspirin is not typically used for this condition. Methotrexate is more commonly used for conditions like rheumatoid arthritis, not giant cell arthritis. Albuterol is a bronchodilator used for respiratory conditions, not for giant cell arthritis.