Nokea
A client with type 1 diabetes is diagnosed with diabetic ketoacidosis and initially treated with intravenous fluids followed by an IV bolus of regular insulin. The nurse anticipates that the practitioner will prescribe a continuous infusion of insulin of:
- A. Novolin L insulin
- B. Novolin R insulin
- C. Novolin N insulin
- D. Novolin U insulin
Correct Answer: B
Rationale: The correct answer is Novolin R (Regular insulin). Regular insulin is used for continuous infusion to treat diabetic ketoacidosis due to its rapid onset of action. Novolin L (Intermediate-acting insulin) (choice A), Novolin N (Intermediate-acting insulin) (choice C), and Novolin U (Ultra-Long-acting insulin) (choice D) are not suitable for continuous infusion in the treatment of diabetic ketoacidosis.
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When is Aspirin most effective when taken?
- A. On an empty stomach with cold water
- B. On a full stomach after a meal
- C. With a glass of fruit juice
- D. First thing in the morning
Correct Answer: A
Rationale: Aspirin is best absorbed on an empty stomach to maximize its effectiveness. Taking it with cold water helps to enhance absorption. Choice B is incorrect as taking aspirin on a full stomach may reduce its absorption. Choice C is incorrect as fruit juice can sometimes interact with medications. Choice D is incorrect as taking aspirin first thing in the morning may not optimize its absorption.
For which client situation would a consultation with a rapid response team (RRT) be most appropriate?
- A. 45-year-old; 2 years post kidney transplant; second hospital day for treatment of pneumonia; no urine output for 6 hours; temperature 101.4°F; heart rate of 98 beats per minute; respirations 20 breaths per minute; blood pressure 88/72 mm Hg; is restless
- B. 72-year-old; 24 hours after removal of a chest tube that was used to drain pleural fluid (effusion); temperature 97.8°F; heart rate 92 beats per minute; respirations 28 breaths per minute; blood pressure 132/86 mm Hg; anxious about going home
- C. 56-year-old fourth hospital day after a coronary artery bypass procedure; sore chest; pain with walking temperature 97°F; heart rate 84 beats per minute; respirations 22 breaths per minute; blood pressure 87/72 mm Hg; bored with hospitalization.
- D. 86-year-old; 48 hours postoperative repair of a fractured hip (nail inserted; alert; oriented; using patient-controlled analgesia (PCA) pump; temperature 96.8°F; heart rate 60 beats per minute; respirations 16 breaths per minute; blood pressure 90/62 mm Hg; talking with daughter.
Correct Answer: A
Rationale: A consultation with a Rapid Response Team (RRT) is most appropriate for the 45-year-old client described in Choice A. This client is 2 years post kidney transplant, presenting with no urine output for 6 hours, a temperature of 101.4°F, heart rate of 98 beats per minute, respirations of 20 breaths per minute, and a blood pressure of 88/72 mm Hg, along with restlessness. These clinical signs are indicative of possible acute renal failure and sepsis, requiring immediate intervention by the rapid response team. Choices B, C, and D do not present the same level of urgency and severity of symptoms as the client in Choice A, making them less appropriate for consultation with the RRT.
Which of the following describes the four-step method of assessment, planning, implementation, and evaluation?
- A. It is a problem-focused process of continued nursing care
- B. It is an open-ended process of continued nursing care
- C. It is a circular process of continued nursing care
- D. It is a trial-and-error process of continued nursing care
Correct Answer: C
Rationale: The correct answer is C: 'It is a circular process of continued nursing care.' The four-step method of assessment, planning, implementation, and evaluation in nursing is a continuous and cyclical process. Choice A is incorrect because the method is not solely problem-focused; it involves a comprehensive approach. Choice B is incorrect as it does not capture the cyclical nature of the process. Choice D is incorrect as the method is systematic and not based on trial-and-error but rather evidence-based practice.
The nurse is preparing the plan of care for a client with fluid volume deficit. Which interventions should the nurse include in the plan of care?
- A. Monitor vital signs every two (2) hours until stable
- B. Weigh the client in the same clothing at the same time daily
- C. Administer mouth care every eight (8) hours
- D. A, B, and C
Correct Answer: D
Rationale: The correct interventions to include in the plan of care for a client with fluid volume deficit are monitoring vital signs every two hours until stable, weighing the client in the same clothing at the same time daily, and assessing skin turgor. These interventions are crucial for managing and detecting fluid volume changes. Administering mouth care every eight hours is not directly related to managing fluid volume deficit and does not address the key aspects of monitoring and assessing fluid status, making it an incorrect choice.
Which hospital level is a 296-bed facility that is staffed and equipped to provide care for all categories of patients?
- A. FSB
- B. CSH
- C. GH
- D. FH
Correct Answer: C
Rationale: The correct answer is "GH" (General Hospital), which is a 296-bed facility providing comprehensive care for all categories of patients. Choice A, FSB, is incorrect as it does not denote a hospital level. Choice B, CSH, is incorrect as it does not specify a 296-bed facility. Choice D, FH, is incorrect as it does not indicate a hospital level or capacity.