Nokea
A nurse caring for a group of clients reviews the electrolyte laboratory results and notes a sodium level of 130 mEq/L on one client's laboratory report. The nurse understands that which client is at highest risk for the development of a sodium value at this level?
- A. The client with renal failure
- B. The client who is taking diuretics
- C. The client with hyperaldosteronism
- D. The client who is taking corticosteroids
Correct Answer: B
Rationale: The correct answer is B. Clients taking diuretics are at risk for hyponatremia due to excessive sodium loss. In this scenario, a sodium level of 130 mEq/L indicates hyponatremia, which is commonly associated with diuretic use. Options A, C, and D are not the highest risk factors for developing low sodium levels in this context. Renal failure, hyperaldosteronism, and corticosteroid use are not directly linked to sodium loss as seen with diuretics.
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You are performing a neurological assessment of your adolescent patient. The patient has the Moro reflex. How should you interpret this neurological assessment finding?
- A. It is normal among adolescents.
- B. It indicates that the patient has an intact peripheral nervous system.
- C. It indicates that the patient has an intact central nervous system.
- D. It is not a normal finding.
Correct Answer: D
Rationale: The Moro reflex, also known as the startle reflex, is typically present in infants up to around 4-6 months of age and is characterized by the infant's response to a sudden loss of support or loud noise. It is not a normal finding in adolescents or older individuals. Therefore, if an adolescent patient exhibits the Moro reflex during a neurological assessment, it is considered abnormal and warrants further evaluation. Choices A, B, and C are incorrect because the Moro reflex is not expected or normal among adolescents and does not specifically indicate the status of either the peripheral or central nervous system in this age group.
Which technique or method is used to determine whether or not the patient has an irregular pulse?
- A. Apical pulse
- B. Inspection
- C. Auscultation
- D. Percussion
Correct Answer: A
Rationale: An apical pulse check is used to determine if the patient has an irregular pulse. The apical pulse is located at the point of maximal impulse (PMI) and is assessed using a stethoscope. Choice B, inspection, involves visual examination and is not used to assess pulse irregularities. Choice C, auscultation, involves listening to internal sounds using a stethoscope, which can be used to assess heart sounds but not specifically for pulse irregularities. Choice D, percussion, is a technique used to assess the density of body tissues or detect abnormal masses and is not used to determine pulse irregularities.
Which of the following changes was enacted by the Patient Protection and Affordable Care Act?
- A. Creation of national health insurance exchanges for affordable insurance coverage
- B. Expansion of school-based health centers
- C. Free preventative services for all
- D. Medically managed clinics eligible for federal funding
Correct Answer: B
Rationale: The correct answer is B. The Patient Protection and Affordable Care Act expanded school-based health centers to provide additional healthcare services to students. Choice A is incorrect because the creation of national health insurance exchanges was a key provision of the Affordable Care Act, but it was not the only change enacted by the legislation. Choice C is incorrect as while the Affordable Care Act did include provisions for free preventative services for certain groups, it was not applicable to all individuals. Choice D is incorrect as the Act did not specifically address medically managed clinics eligible for federal funding.
Based on the signs and symptoms of erythema marginatum, Sydenham chorea, epistaxis, abdominal pain, fever, cardiac problems, and skin nodules in your 32-year-old female patient, what disorder would you most likely suspect?
- A. Leukemia
- B. Histoplasmosis
- C. Pneumocystis jiroveci
- D. Rheumatoid arthritis
Correct Answer: D
Rationale: The signs and symptoms described point towards rheumatoid arthritis. Erythema marginatum, Sydenham chorea, epistaxis, abdominal pain, fever, cardiac issues, and skin nodules are classic manifestations of rheumatic fever, which is a complication of untreated streptococcal infection. This condition can lead to rheumatoid arthritis over time. Choices A, B, and C are incorrect as they do not align with the provided signs and symptoms, and they are not associated with the clinical presentation described.
A nurse is preparing to complete an incident report regarding a medication error. Which of the following actions should the nurse plan to take?
- A. Make a copy of the incident report for personal records
- B. Identify the medication name and dosage administered to the client in the report
- C. Obtain an order from the client's provider to complete the report
- D. Include the time the medication error occurred in the report
Correct Answer: B
Rationale: The correct answer is to identify the medication name and dosage administered to the client in the incident report. This information is crucial for accurate documentation and investigation of the medication error. Choice A is incorrect because incident reports are usually kept confidential and not for personal keeping. Choice C is incorrect as obtaining an order from the client's provider is not necessary to complete an incident report. Choice D, while important, is not the only essential information needed for the incident report.