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A guest who is diabetic attended a bridal affair. The guest started to tremble and started to feel dizzy. Luckily a nurse is present. The best action for the nurse to take is to:
- A. encourages the guest to eat some
- B. call the guest’s personal hygiene
- C. offer the guest a peppermint
- D. give the guest a glass of orange juice
Correct Answer: D
Rationale: The correct answer is D: give the guest a glass of orange juice. This is the best action because the guest is likely experiencing hypoglycemia due to being diabetic. Orange juice contains fast-acting sugar that can quickly raise blood sugar levels. Encouraging the guest to eat some (choice A) may take longer to have an effect. Calling the guest's personal hygiene (choice B) is irrelevant to the situation. Offering the guest a peppermint (choice C) will not effectively raise blood sugar levels.
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A client with HIV has been prescribed anti viral medications. What instructions related to administration of medications should the nurse give such a client?
- A. Comply with the timing of antiviral medication around meals
- B. Avoid exposure to harsh sunlight for about 2hrs after taking the medication
- C. Have the medications with plenty of fruit juice
- D. Have an increased dose of the medications if the symptoms worsen
Correct Answer: A
Rationale: Correct Answer: A
Rationale:
1. Timing: Antiviral medications should be taken as prescribed to maintain consistent drug levels in the body.
2. Around meals: Taking medications with or without food can affect absorption, so timing around meals helps with consistency.
3. Compliance: Following the timing instructions increases medication effectiveness and reduces the risk of drug resistance.
Other Choices:
B) Avoiding harsh sunlight: Not directly related to medication administration; may be a precaution for other reasons.
C) Having medications with fruit juice: This is not a standard instruction for antiviral medications; may not be suitable for all medications.
D) Increasing dose for worsening symptoms: This is dangerous and should only be done under healthcare provider supervision; self-adjusting medication doses can be harmful.
What is an important consideration regarding TPN administration?
- A. IV site is kept aseptic while infusing the solution
- B. Feeding is poured into a pouch and then infused
- C. Solution is only hung for a maximum of 8 hours at a time
- D. New formula is added as needed so the line does not run dry
Correct Answer: A
Rationale: Correct Answer: A
Rationale:
1. Aseptic technique prevents infection at IV site.
2. TPN is a high-risk solution, requiring strict aseptic administration.
3. Contaminated site can lead to sepsis or other serious complications.
4. Choice B increases risk of contamination.
5. Choice C increases risk of bacterial growth.
6. Choice D may introduce air or contamination.
Summary:
Choice A is correct as it emphasizes infection prevention. Choices B, C, and D pose risks of contamination, bacterial growth, or air introduction.
The NAP states that was busy and had not had a chance to tell the nurse yet. The patient begins to complain of feeling dizzy and light-headed. The blood pressure is rechecked and it has dropped even lower. In which phase of the nursing process did the nurse first make an error? NursingStoreRN
- A. Assessment
- B. Diagnosis
- C. Implementation
- D. Evaluation
Correct Answer: A
Rationale: The correct answer is A: Assessment. In this scenario, the nurse failed to complete a thorough assessment by not informing the nurse about the patient's condition. Assessment is the first step in the nursing process where data is collected and analyzed to identify the patient's problems. By not communicating the patient's symptoms to the nurse, the nurse missed crucial information that could have led to timely intervention.
Explanation of other choices:
B: Diagnosis - The nurse did not have the opportunity to make a diagnosis because the assessment phase was incomplete.
C: Implementation - The nurse did not reach the implementation phase yet as the assessment phase was not properly conducted.
D: Evaluation - The nurse cannot evaluate the effectiveness of interventions as the assessment and subsequent phases were not properly carried out.
Which of the ff. is a normal hemoglobin value?
- A. 38% to 48%
- B. 48 to 54 mg%
- C. 12 to 18 g/100mL
- D. 27 to 36 g/dL
Correct Answer: C
Rationale: The correct answer is C: 12 to 18 g/100mL. Normal hemoglobin values typically range from 12 to 18 g/100mL in adults. This range reflects the normal concentration of hemoglobin in the blood and is commonly used as a reference range in clinical practice. Choices A, B, and D are incorrect because they do not fall within the typical normal range for hemoglobin levels. Choice A (38% to 48%) is a percentage range, not a direct measurement of hemoglobin concentration. Choice B (48 to 54 mg%) and Choice D (27 to 36 g/dL) are outside the normal range for hemoglobin levels in adults. Therefore, the most appropriate and accurate choice among the options provided is C (12 to 18 g/100mL) based on standard reference values for hemoglobin concentration in the blood.
A client with cancer that has metastazised to the liver is started on chemotherapy- His physician has specified divided doses of the antimetabolite. The client asks why he could take the drug in divided doses. The appropriate response is:
- A. " There really is no reason your doctor just wrote the orders that way."
- B. "This schedule will reduce the side effect of the drug."
- C. "Divided doses produce greater cytotoxic effects on the diseased cells."
- D. "Because these drugs prevent cell division, they are more effective in divided doses,"
Correct Answer: C
Rationale: The correct answer is C: "Divided doses produce greater cytotoxic effects on the diseased cells." Dividing the doses of the antimetabolite allows for more consistent levels of the drug in the bloodstream, ensuring sustained exposure to the cancer cells. This continuous exposure enhances the drug's cytotoxic effects, increasing its efficacy in targeting and destroying the diseased cells. Options A and B provide vague or incorrect information, while option D is misleading as antimetabolites do not prevent cell division, but rather disrupt DNA synthesis.