Nokea
A client with liver failure is at an increased risk of bleeding due to the inability to synthesize prothrombin in the liver. What factor most likely contributes to this loss of function?
- A. Alterations in glucose metabolism
- B. Retention of bile salts
- C. Inadequate production of albumin by hepatocytes
- D. Inability of the liver to use vitamin K
Correct Answer: D
Rationale: The correct answer is D: Inability of the liver to use vitamin K. Vitamin K is essential for the synthesis of clotting factors, including prothrombin. In liver failure, impaired function leads to reduced production of bile, which is necessary for the absorption of fat-soluble vitamins like vitamin K. This results in inadequate activation of clotting factors and increased risk of bleeding. Choices A, B, and C are incorrect as alterations in glucose metabolism, retention of bile salts, and inadequate albumin production do not directly impact the synthesis and activation of clotting factors like prothrombin in liver failure.
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A 65-year-old female client arrives in the emergency department with shortness of breath and chest pain. The nurse accidentally administers 10 mg of morphine sulfate instead of the prescribed 4 mg. Later, the client's respiratory rate is 10 breaths/minute, oxygen saturation is 98%, and she states her pain has subsided. What is the legal status of the nurse?
- A. The nurse is guilty of negligence and will be sued.
- B. The client would not be able to prove malpractice in court.
- C. The nurse is protected by the Good Samaritan Act.
- D. The healthcare provider should have given the morphine sulfate dose.
Correct Answer: B
Rationale: The correct answer is B: The client would not be able to prove malpractice in court. In this scenario, although the nurse made an error in administering a higher dose of morphine, the client's condition improved, as evidenced by stable vital signs and pain relief. Therefore, there was no harm caused to the client due to the mistake. In malpractice cases, the client needs to prove that harm or injury resulted from the healthcare provider's actions. Since the client's condition improved, it would be difficult to establish malpractice in this situation.
Choice A is incorrect because negligence requires harm or injury to occur, which is not the case here. Choice C is incorrect as the Good Samaritan Act typically applies to individuals providing emergency care in good faith at the scene of an emergency, not within a healthcare setting. Choice D is incorrect as the focus is on the nurse's error in administering the incorrect dose, not on the healthcare provider's responsibility in this context.
The preceptor is orienting a new graduate nurse to the critical care unit. The preceptor asks the new graduate to state symptoms that most likely indicate the beginning of a shock state in a critically ill client. What findings should the new graduate nurse identify?
- A. Warm skin, hypertension, and constricted pupils.
- B. Bradycardia, hypotension, and respiratory acidosis.
- C. Mottled skin, tachypnea, and hyperactive bowel sounds.
- D. Tachycardia, mental status change, and low urine output.
Correct Answer: D
Rationale: The correct answer is D: Tachycardia, mental status change, and low urine output. In the early stages of shock, the body compensates by increasing heart rate (tachycardia) to maintain perfusion. Mental status change can indicate decreased cerebral perfusion. Low urine output is a sign of decreased renal perfusion.
A: Warm skin, hypertension, and constricted pupils are not indicative of shock. In shock, skin becomes cool and clammy, blood pressure drops, and pupils dilate.
B: Bradycardia, hypotension, and respiratory acidosis are not early signs of shock. Bradycardia and hypotension occur in the late stages of shock. Respiratory acidosis is a complication of shock, not an early symptom.
C: Mottled skin, tachypnea, and hyperactive bowel sounds are signs of shock but not early indicators. Mottled skin appears in the late stages of shock, tach
A client is being educated about type 2 diabetes. The educator can confirm that the client understands the primary treatment for type 2 diabetes when the client states what?
- A. I read that a pancreas transplant will provide a cure for my diabetes.
- B. I will take my oral antidiabetic agents when my morning blood sugar is high.
- C. I will make sure to follow the weight loss plan designed by the dietitian.
- D. I will make sure I call the diabetes educator when I have questions about my insulin.
Correct Answer: C
Rationale: Correct Answer: C
Rationale:
1. Weight loss helps improve insulin sensitivity.
2. Managing weight is crucial for controlling blood sugar levels.
3. Dietitian-designed plans focus on balanced nutrition for diabetes management.
4. Weight loss can reduce the need for medication and improve overall health.
Summary of Incorrect Choices:
A: Pancreas transplant is not a primary treatment for type 2 diabetes.
B: Taking oral antidiabetic agents based on blood sugar levels is not ideal.
D: Contacting the diabetes educator for insulin questions is important but not primary treatment.
A healthcare professional is educating a group of recent nursing graduates about their risks for contracting hepatitis B. What preventative measure should the professional promote?
- A. Immunization
- B. Chronic tonsillitis
- C. Consumption of a vitamin-rich diet
- D. Annual vitamin K injections
Correct Answer: A
Rationale: The correct answer is A: Immunization. Hepatitis B is a viral infection transmitted through exposure to infected blood or body fluids. Immunization with the hepatitis B vaccine is the most effective preventative measure, providing long-term protection against the virus. Chronic tonsillitis (B) is unrelated to hepatitis B prevention. Consumption of a vitamin-rich diet (C) and annual vitamin K injections (D) do not offer protection against hepatitis B. Immunization is the best choice due to its proven efficacy in preventing hepatitis B transmission.
A 48-year-old man presents with fatigue, weight gain, and cold intolerance. Laboratory tests reveal high TSH and low free T4 levels. What is the most likely diagnosis?
- A. Hypothyroidism
- B. Hyperthyroidism
- C. Thyroiditis
- D. Thyroid cancer
Correct Answer: A
Rationale: The correct answer is A: Hypothyroidism. In this scenario, the patient has symptoms of hypothyroidism (fatigue, weight gain, cold intolerance) along with high TSH and low free T4 levels, indicating primary hypothyroidism. TSH is elevated as the body is trying to stimulate the thyroid to produce more thyroid hormones. Free T4 is low as the thyroid is not able to produce enough hormones. Hyperthyroidism (choice B) would present with low TSH and high free T4 levels. Thyroiditis (choice C) typically presents with symptoms of hyperthyroidism followed by hypothyroidism. Thyroid cancer (choice D) usually does not cause these specific symptoms and lab findings. Therefore, based on the symptoms and lab results, hypothyroidism is the most likely diagnosis.