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A nurse is assessing a patient with chronic kidney disease. The nurse should prioritize which of the following lab values?
- A. Serum creatinine levels.
- B. Hemoglobin levels.
- C. White blood cell count.
- D. Platelet count.
Correct Answer: A
Rationale: The correct answer is A: Serum creatinine levels. In patients with chronic kidney disease, monitoring serum creatinine levels is crucial because it reflects kidney function. An increase in creatinine levels indicates worsening kidney function. Hemoglobin levels (B) are important in assessing anemia, common in CKD, but not the priority. White blood cell count (C) and platelet count (D) may indicate infection or bleeding, respectively, but are not specific to kidney function in this context.
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A patient with diabetes is experiencing a hypoglycemic episode. Which of the following is the nurse's first priority in this situation?
- A. Administering insulin.
- B. Providing a source of fast-acting carbohydrate.
- C. Checking the patient's blood glucose level.
- D. Contacting the healthcare provider.
Correct Answer: B
Rationale: The correct answer is B: Providing a source of fast-acting carbohydrate. In a hypoglycemic episode, the priority is to raise the blood sugar quickly to prevent further complications. Fast-acting carbohydrates such as glucose tablets or orange juice can rapidly increase blood sugar levels. Administering insulin (choice A) can further lower blood sugar, checking blood glucose levels (choice C) may delay treatment, and contacting the healthcare provider (choice D) is not necessary in the immediate management of hypoglycemia.
A nurse is assessing a 45-year-old male patient with a history of smoking. The nurse would be most concerned if the patient reports:
- A. Shortness of breath with minimal exertion.
- B. Occasional cough with mucus production.
- C. Slight wheezing after physical activity.
- D. Experiencing no symptoms related to smoking.
Correct Answer: A
Rationale: The correct answer is A because shortness of breath with minimal exertion indicates possible respiratory distress, which can be a sign of significant lung damage from smoking. This symptom suggests a decreased ability to exchange oxygen and carbon dioxide efficiently, potentially leading to serious health complications.
Choice B is incorrect because an occasional cough with mucus production is common in smokers and may not be as alarming as shortness of breath.
Choice C is incorrect as slight wheezing after physical activity could be due to exercise-induced asthma rather than solely smoking-related issues.
Choice D is incorrect because even though the patient may not be experiencing symptoms related to smoking currently, it does not rule out potential underlying lung damage or future health risks associated with smoking.
A nurse is caring for a patient who has a history of myocardial infarction. The nurse should prioritize which of the following assessments?
- A. Blood pressure and heart rate.
- B. Temperature and respiratory rate.
- C. Bowel sounds and abdominal girth.
- D. Urine output and skin integrity.
Correct Answer: A
Rationale: The correct answer is A: Blood pressure and heart rate. This is crucial in assessing the cardiac function of a patient with a history of myocardial infarction. Monitoring blood pressure and heart rate helps in evaluating cardiovascular status and detecting any potential complications. Abnormal values in these parameters can indicate inadequate perfusion to the heart or other organs, which can be life-threatening.
Other choices are incorrect because:
B: Temperature and respiratory rate are important assessments but not the priority for a patient with a history of myocardial infarction.
C: Bowel sounds and abdominal girth are more relevant for gastrointestinal issues and not a priority in this scenario.
D: Urine output and skin integrity are important assessments for overall health but do not directly relate to the cardiovascular status in a patient with a history of myocardial infarction.
Expert nurses learn to attend to a pattern of assessment data and act without consciously labelling it. This is referred to as:
- A. intuition.
- B. the nursing process.
- C. clinical knowledge.
- D. diagnostic reasoning.
Correct Answer: A
Rationale: The correct answer is A: intuition. Expert nurses develop intuition through years of experience, allowing them to recognize patterns in assessment data and act quickly without conscious labeling. This intuitive response is based on a deep understanding of situations and is often more efficient than consciously going through the nursing process. Clinical knowledge (C) is important but refers to theoretical understanding. The nursing process (B) involves systematic steps in patient care, not the automatic response seen in intuition. Diagnostic reasoning (D) involves a more deliberate thought process in identifying and treating health issues.
Which of the following statements accurately reflects the concept of ethnicity?
- A. Ethnicity is dynamic and ever changing because of political forces.
- B. Ethnicity refers to a group that shares heritage, culture, language, or religion.
- C. Ethnicity refers to the belief in a higher power or being.
- D. Ethnicity is a learned behaviour that includes language and socialization.
Correct Answer: B
Rationale: The correct answer is B because ethnicity is defined by shared heritage, culture, language, or religion. This definition encompasses the key components that make up an individual's ethnic identity. Choice A is incorrect because while political forces may influence ethnicity, it does not define the concept itself. Choice C is incorrect as ethnicity is not necessarily related to belief in a higher power. Choice D is incorrect as ethnicity is not solely a learned behavior but also includes innate aspects like heritage.