Nokea
A client with terminal pancreatic cancer asks questions about a do not resuscitate order. Which of the following statements should be included in the RN's teaching to the client?
- A. When a heart ceases to beat, the client is pronounced clinically dead.
- B. Physicians must write do not resuscitate (DNR) orders.
- C. A DNR order can be written after the healthcare provider has discussed it with the client and family.
- D. A DNR requires a court decision.
Correct Answer: C
Rationale: A DNR order is typically written after the healthcare provider has discussed the implications with the patient and their family. This ensures that the patient and family are fully informed before making such a critical decision. Choice A is incorrect because pronouncing clinical death is a medical determination, not directly related to DNR orders. Choice B is incorrect because while physicians commonly write DNR orders, the discussion with the patient and family is crucial. Choice D is incorrect because a DNR order does not require a court decision; it is a decision made in collaboration with the healthcare team and the patient or family.
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A male client is admitted for treatment of the syndrome of inappropriate antidiuretic hormone (SIADH). Which nursing intervention is appropriate?
- A. Infusing I.V. fluids rapidly as ordered
- B. Encouraging increased oral intake
- C. Restricting fluids
- D. Administering glucose-containing I.V. fluids as ordered
Correct Answer: C
Rationale: The correct nursing intervention for a male client with SIADH is to restrict fluids. In SIADH, there is excess release of antidiuretic hormone (ADH), leading to water retention and dilutional hyponatremia. Restricting fluids helps prevent further dilutional hyponatremia by reducing water intake. Infusing I.V. fluids rapidly (choice A) would worsen the condition by adding more fluids, encouraging increased oral intake (choice B) is contraindicated as it adds more fluids, and administering glucose-containing I.V. fluids (choice D) is not a standard treatment for SIADH.
Which of the following traits is characteristic of a caring leader?
- A. A caring leader serves first and leads second.
- B. A caring leader is aware of the feelings of others.
- C. The traits of a caring leader include respecting coworkers as individuals and empathizing with the needs and concerns of others.
- D. A caring leader is fair and honest.
Correct Answer: C
Rationale: A caring leader is characterized by respecting coworkers as individuals and empathizing with their needs and concerns. Choice A is more about servant leadership rather than specifically about caring leadership. Choice B, while related to empathy, does not encompass the full spectrum of traits associated with a caring leader. Choice D, being fair and honest, is important in leadership but does not solely define a caring leader.
The client with DM who is taking insulin develops a fever and becomes confused. Which action should the nurse take first?
- A. Check the client's blood glucose level.
- B. Administer a fever-reducing medication.
- C. Give the client fluids to drink.
- D. Notify the health care provider.
Correct Answer: A
Rationale: In a client with diabetes mellitus (DM) taking insulin, the development of fever and confusion may indicate hyperglycemia or diabetic ketoacidosis. Checking the blood glucose level is the priority action in this situation. This will help determine if the symptoms are related to high blood sugar levels, guiding further interventions. Administering a fever-reducing medication (choice B) addresses only the symptom of fever and does not address the underlying cause. Providing fluids to drink (choice C) is important but should come after addressing the potential hyperglycemia or diabetic ketoacidosis. Notifying the health care provider (choice D) can be important, but immediate action to evaluate and manage the client's condition should precede contacting the provider.
The healthcare provider is providing dietary instructions to a client with hyperthyroidism. Which of the following foods should the client avoid?
- A. Seafood
- B. Spinach
- C. Bananas
- D. Oatmeal
Correct Answer: A
Rationale: The client with hyperthyroidism should avoid foods high in iodine, as it can exacerbate the condition by increasing thyroid hormone production. Seafood, particularly ocean fish, is rich in iodine, making it a food to avoid. Spinach, bananas, and oatmeal do not contain high levels of iodine and are generally safe for individuals with hyperthyroidism.
A client with hyperaldosteronism is at risk for which of the following electrolyte imbalances?
- A. Hyperkalemia
- B. Hyponatremia
- C. Hypokalemia
- D. Hypercalcemia
Correct Answer: C
Rationale: In hyperaldosteronism, there is an excessive secretion of aldosterone, a hormone that promotes potassium excretion in the kidneys. This leads to low potassium levels in the blood, known as hypokalemia. Therefore, the correct answer is hypokalemia (Choice C). Hyperkalemia (Choice A) is the opposite condition, where there is high potassium levels in the blood and is not typically associated with hyperaldosteronism. Hyponatremia (Choice B) is a low sodium level, which is not directly related to aldosterone function. Hypercalcemia (Choice D) is an elevated calcium level and is not typically a direct result of hyperaldosteronism.