Nokea
A healthcare provider is reviewing laboratory results for a client who has diabetes mellitus. Which of the following tests is an indicator of long-term blood glucose control?
- A. Fasting blood glucose
- B. Glycosylated hemoglobin (HbA1c)
- C. Random blood glucose
- D. Postprandial blood glucose
Correct Answer: B
Rationale: The correct answer is B, Glycosylated hemoglobin (HbA1c). HbA1c provides a measure of long-term blood glucose control over the past 2-3 months. This test reflects the average blood glucose levels during this period, making it a valuable tool in managing diabetes. Choices A, C, and D are not indicators of long-term blood glucose control. Fasting blood glucose measures the current glucose level after a period of not eating, random blood glucose provides a snapshot of the current glucose level, and postprandial blood glucose measures the glucose level after a meal.
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What is the most concerning electrolyte imbalance for a patient receiving digoxin?
- A. Hyperkalemia
- B. Hypokalemia
- C. Hyponatremia
- D. Hypercalcemia
Correct Answer: B
Rationale: The correct answer is Hypokalemia. Hypokalemia is the most concerning electrolyte imbalance for a patient receiving digoxin because it can increase the risk of digoxin toxicity. Low potassium levels can potentiate the effects of digoxin on the heart, leading to serious cardiac arrhythmias. Hyperkalemia (Choice A) is not typically associated with digoxin use. Hyponatremia (Choice C) and Hypercalcemia (Choice D) are not directly related to digoxin therapy and do not pose the same risk of toxicity.
Four clients present to the emergency department. The nurse should plan to see which of the following clients first?
- A. A 6-year-old client with a dislocated left shoulder
- B. A 26-year-old client with sickle cell disease and severe joint pain
- C. A 76-year-old client who is confused, febrile, and has foul-smelling urine
- D. A 50-year-old client with slurred speech, disorientation, and headache
Correct Answer: D
Rationale: The correct answer is D. A client presenting with symptoms of a stroke, such as slurred speech, disorientation, and headache, requires immediate attention due to the possibility of a neurological emergency. Choices A, B, and C, although concerning, do not present with symptoms as urgent as those of a potential stroke. Dislocated shoulder, sickle cell disease with joint pain, and confusion with febrile illness can be addressed after ensuring the client with stroke-like symptoms receives prompt evaluation and intervention.
A client is postoperative following cataract surgery. Which of the following instructions should the nurse include?
- A. Avoid lying flat for 24 hours after surgery.
- B. Avoid bending at the waist.
- C. Wear an eye patch at night for 1 week.
- D. Sleep on your affected side to reduce discomfort.
Correct Answer: B
Rationale: The correct instruction that the nurse should include for a client postoperative following cataract surgery is to avoid bending at the waist. Bending at the waist can increase intraocular pressure, which is not recommended after cataract surgery. Choices A, C, and D are incorrect because lying flat for 24 hours after surgery may not be necessary, wearing an eye patch at night for a week is not a standard postoperative instruction for cataract surgery, and sleeping on the affected side may not necessarily reduce discomfort and can increase pressure on the eye.
A client is 2 days postoperative following a hip replacement surgery. Which of the following findings should the nurse report to the provider?
- A. Heart rate of 88/min
- B. Redness and warmth in the calf
- C. Urine output of 30 mL/hr
- D. Heart rate of 96/min
Correct Answer: B
Rationale: Redness and warmth in the calf can indicate a deep vein thrombosis (DVT), which is a serious complication following hip replacement surgery. It is crucial to report this finding promptly for further evaluation and intervention. The other options, heart rates of 88/min and 96/min, are within normal limits for an adult and may not require immediate reporting. A urine output of 30 mL/hr is concerning for decreased kidney perfusion, but the priority in this case is the potential DVT due to its severe implications.
What is the priority nursing action for a patient with respiratory distress?
- A. Administer oxygen
- B. Reposition the patient
- C. Administer bronchodilators
- D. Provide chest physiotherapy
Correct Answer: A
Rationale: The priority nursing action for a patient with respiratory distress is to administer oxygen. Oxygen therapy is crucial in improving oxygenation levels and relieving respiratory distress, making it the top priority intervention. Repositioning the patient, administering bronchodilators, or providing chest physiotherapy may be necessary interventions depending on the underlying cause, but ensuring adequate oxygen supply should take precedence in addressing respiratory distress.