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A nurse in an emergency department is caring for a patient who has diabetic ketoacidosis (DKA) and a blood glucose level of 925 mg/dL. What prescription should the nurse anticipate from the provider? What prescription should the nurse anticipate for DKA?
- A. Glucocorticoid medications.
- B. Dextrose 5% in 0.45% sodium chloride.
- C. Oral hypoglycemic medications.
- D. 0.9% sodium chloride IV bolus.
Correct Answer: D
Rationale: The correct answer is D: 0.9% sodium chloride IV bolus. In DKA, the primary concern is severe dehydration and electrolyte imbalances due to high blood glucose levels. 0.9% sodium chloride helps to rehydrate the patient and correct electrolyte imbalances. Glucocorticoids (A) are not typically used in the treatment of DKA. Dextrose 5% in 0.45% sodium chloride (B) would worsen hyperglycemia. Oral hypoglycemic medications (C) are not appropriate for managing acute DKA. Therefore, the nurse should anticipate the prescription of 0.9% sodium chloride IV bolus to address the immediate needs of the patient with DKA.
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A nurse is caring for a patient who is receiving a blood transfusion. The patient reports chills and back pain 15 minutes after the transfusion begins. Which of the following actions should the nurse take first? What should the nurse do first for transfusion reaction symptoms?
- A. Slow the transfusion rate.
- B. Stop the transfusion.
- C. Administer acetaminophen.
- D. Notify the provider.
Correct Answer: B
Rationale: The correct answer is B: Stop the transfusion. When a patient develops symptoms of a transfusion reaction such as chills and back pain, it is crucial to stop the transfusion immediately to prevent further complications. This action takes priority over other options as it ensures patient safety. Slowing the transfusion rate (choice A) may not be sufficient to address the reaction promptly. Administering acetaminophen (choice C) may help alleviate symptoms but does not address the underlying cause. Notifying the provider (choice D) is important but should come after stopping the transfusion to address the immediate issue.
A nurse is caring for a patient receiving epidural analgesia for pain during labor. Which of the following observations should be the nurse's priority? Which observation is the priority for epidural analgesia?
- A. The patient's blood pressure is 80/56 mm Hg.
- B. The patient reports lower extremity weakness.
- C. The patient's temperature is 38.2°C (100.8 F).
- D. The patient reports severe itching.
Correct Answer: A
Rationale: The correct answer is A: The patient's blood pressure is 80/56 mm Hg. This is the priority observation because hypotension is a common side effect of epidural analgesia, which can lead to decreased perfusion and compromise fetal well-being. Lower extremity weakness (B) is expected due to the effect of the epidural. Temperature elevation (C) can be due to various factors unrelated to the epidural. Severe itching (D) can be a side effect but is not life-threatening like hypotension.
A nurse is caring for a patient who is postoperative following a cholecystectomy. Which of the following findings should the nurse report to the provider? Which finding post-cholecystectomy should the nurse report?
- A. Clay-colored stools
- B. Mild abdominal pain
- C. Nausea
- D. Fatigue
Correct Answer: A
Rationale: Correct Answer: A: Clay-colored stools
Rationale: Clay-colored stools can indicate a potential issue with bile flow, which is crucial post-cholecystectomy. Absence of bile in the stool may suggest a blocked bile duct, leading to complications like jaundice or infection. This finding should be reported promptly for further evaluation and management.
Summary of other choices:
- B: Mild abdominal pain is common post-surgery and can be managed with pain medications.
- C: Nausea is also expected after surgery and can be managed with antiemetics.
- D: Fatigue is a common postoperative symptom and may improve with rest and proper nutrition.
A nurse is caring for a patient who has a new prescription for omeprazole. Which of the following instructions should the nurse include? What instructions should the nurse include for omeprazole?
- A. Take the medication with food.
- B. Take the medication on an empty stomach.
- C. Take the medication at bedtime.
- D. Avoid taking with antacids.
Correct Answer: B
Rationale: The correct answer is B: Take the medication on an empty stomach. Omeprazole is a proton pump inhibitor that works best when taken on an empty stomach, at least 30 minutes before a meal. This allows for optimal absorption and effectiveness in reducing stomach acid production. Taking it with food may decrease its absorption and effectiveness. Choice A is incorrect because taking omeprazole with food can interfere with its absorption. Choice C is incorrect as taking it at bedtime may not provide the best conditions for absorption. Choice D is incorrect because omeprazole can be taken with antacids if needed, but it's best to separate the doses by at least 2 hours.
A patient with a history of migraines is at the clinic complaining of a throbbing headache. Which of the following questions should the nurse include in the assessment? Which question should the nurse ask for migraine assessment?
- A. Have you experienced any nausea or vomiting with your headache?
- B. Are the lights in this room bothering you?
- C. Have you noticed any confusion or clouded thinking?
- D. Did you feel weak before the headache started or do you feel weak now?
Correct Answer: A
Rationale: The correct answer is A: "Have you experienced any nausea or vomiting with your headache?" This question is crucial in assessing migraines as nausea and vomiting are common accompanying symptoms. Nausea and vomiting are associated with activation of the autonomic nervous system during migraines. The other options are not as directly related to migraines. B is more relevant to light sensitivity in migraines, C is more related to confusion or cognitive symptoms, and D is more focused on weakness, which are not typically primary symptoms of migraines.