A home health nurse is reviewing the laboratory results for several clients with heart failure. Which client finding would the nurse report to the health care provider immediately?
- A. total cholesterol 190
- B. glycosylated hemoglobin of 7%
- C. B-type natriuretic peptide 550 pg/ml (more than 100 is bad)
- D. potassium 3.7
Correct Answer: C
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
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A client with a history of diabetes mellitus is admitted with hypoglycemia. Which finding requires immediate intervention?
- A. Blood glucose of 60 mg/dL.
- B. Heart rate of 100 beats per minute.
- C. Tremors.
- D. Diaphoresis.
Correct Answer: C
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
A 6-year-old child is alert but quiet when brought to the emergency center with periorbital ecchymosis and ecchymosis behind the ears. The nurse suspects potential child abuse and continues to assess the child for additional manifestations of a basilar skull fracture. What assessment finding would be consistent with the basilar skull fracture?
- A. Blurred vision.
- B. Shoulder pain.
- C. Abdominal pain.
- D. Rhinorrhea or otorrhea with halo sign.
Correct Answer: D
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
During a follow-up visit, a client with diabetes reports difficulty maintaining a healthy diet. What should the nurse do first?
- A. provide the client with meal planning resources
- B. explore the client's dietary habits and challenges
- C. refer the client to a nutritionist
- D. educate the client on the importance of a healthy diet
Correct Answer: B
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
A female client reports to the nurse that her sleep was interrupted by 'thoughts of anger towards my husband.' What type of thoughts is the client having?
- A. Obsessive.
- B. Phobic.
- C. Delusional.
- D. Paranoid.
Correct Answer: A
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
An older female client tells the home health nurse that she has no money, and since she does not deserve to eat, she has not asked anyone to bring her food. What information is most important for a nurse to obtain?
- A. client's thoughts about wanting to hurt herself
- B. medication history for antipsychotic agents
- C. availability of family members to provide meals
- D. community resources to provide financial aid
Correct Answer: A
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.