Nokea
A nurse is caring for a client who has diabetes mellitus and has been following a treatment plan for 3 months. Which of the following laboratory results should the nurse monitor to determine long-term glycemic control?
- A. Postprandial blood glucose level
- B. Glycosylated hemoglobin level
- C. Fasting blood glucose level
- D. Oral glucose tolerance test results
Correct Answer: B
Rationale: The correct answer is B: Glycosylated hemoglobin level. This test provides an average blood glucose level over the past 2-3 months, reflecting long-term glycemic control. Monitoring glycosylated hemoglobin levels helps assess the effectiveness of the client's diabetes management plan over time.
A: Postprandial blood glucose level reflects short-term control after a meal.
C: Fasting blood glucose level reflects current blood glucose levels but not long-term control.
D: Oral glucose tolerance test results evaluate how the body handles glucose, not long-term control.
In summary, monitoring glycosylated hemoglobin levels is crucial for assessing long-term glycemic control in clients with diabetes.
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A nurse is teaching a client who has left-sided weakness how to use a quad cane. Which of the following client actions indicates an understanding of the teaching?
- A. The client moves the cane 2 feet ahea
- B. The client advances the weaker leg forward to the cane.
- C. The client takes a step with their right foot first.
- D. The client holds the cane with their left han
Correct Answer: B
Rationale: The correct answer is B. Advancing the weaker leg forward to the cane provides stability and support, helping distribute weight evenly and preventing falls. This step is crucial in using a quad cane effectively. Moving the cane too far ahead (A) could cause imbalance. Taking a step with the stronger leg first (C) would not provide the needed support for the weaker side. Holding the cane with the same side as the weakness (D) may not provide the necessary support. It is essential to prioritize stability and weight distribution, making option B the correct choice.
A nurse is teaching a client about the use of an incentive spirometer. Which of the following instructions should the nurse include in the teaching?
- A. Hold breaths about 3 to 5 seconds before exhaling.'
- B. Exhale slowly through pursed lips.'
- C. Position the mouthpiece 2.5 cm (1 in) from the mouth.'
- D. Place hands on the upper abdomen during inhalation.'
Correct Answer: A
Rationale: Correct Answer: A. Hold breaths about 3 to 5 seconds before exhaling.
Rationale: Holding the breath for a few seconds after inhaling with an incentive spirometer helps to fully expand the lungs and improve lung function. This technique prevents air from escaping too quickly and allows for optimal oxygen absorption. It also encourages deep breathing, which is essential for clearing the airways and improving overall lung capacity.
Summary of other choices:
B: Exhaling slowly through pursed lips is a technique used in pursed lip breathing, not with an incentive spirometer.
C: The position of the mouthpiece is important for comfort but not directly related to using the incentive spirometer.
D: Placing hands on the upper abdomen during inhalation is not a recommended technique for using an incentive spirometer.
A nurse is providing teaching to a client who has a new prescription for levothyroxine to treat hypothyroidism. Which of the following statements by the client indicates an understanding of the teaching?
- A. I will take this medication with food to help with absorption.
- B. If my heart starts racing
- C. my provider might need to adjust my dosage.
- D. I should stop taking this medication once my symptoms improve.
- E. I will take this medication at night before bed.
Correct Answer: B
Rationale: Correct Answer: B - If my heart starts racing
Rationale: This statement indicates an understanding of a potential side effect of levothyroxine, which is palpitations or rapid heart rate. It shows that the client is aware of the importance of monitoring for adverse reactions and seeking medical attention if necessary. This is crucial as it can indicate overmedication, which can be harmful.
Incorrect Choices:
A: Taking levothyroxine with food can interfere with its absorption, reducing its effectiveness.
C: Adjusting the dosage is the healthcare provider's responsibility based on lab results, not the client's decision.
D: Stopping the medication abruptly can lead to a worsening of hypothyroidism symptoms.
E: Taking levothyroxine at night can interfere with sleep patterns and absorption.
A nurse is caring for a client receiving TPN. Which of the following actions should the
nurse take? For each potential nursing intervention, click to specify if the potential intervention
is anticipated, nonessential, or contraindicated for the client.
- A. Request a prescription for insulin
- B. Request for an antibitic to be administered
- C. Decrease the client's oxygen to 1.5 L/min via nasal canula
- D. Have 3 nurses verify the TPN solution prescription
- F. Notify the provider to increase TPN rate/hr
Correct Answer: A,B,C,D
Rationale: [
Anticipated: Request a prescription for insulin, Request for an antibiotic to be administered, Decrease the client's oxygen to 1.5 L/min via nasal cannula, Have 3 nurses verify the TPN solution prescription.
Rationale: A client on TPN may require insulin for glycemic control, antibiotics for infection management, oxygen adjustment for respiratory support, and verification of TPN solution to prevent errors.
Non-essential/Contraindicated: Not applicable as all options are essential in the care of a client receiving TPN.]
A nurse is preparing to administer propranolol to several clients. For which of the following clients should the nurse clarify the prescription with the provider before administration?
- A. A client who has a history of asthma
- B. A client who has hypertension
- C. A client who has a history of migraines
- D. A client who has stable angina
Correct Answer: A
Rationale: The correct answer is A: A client who has a history of asthma. Propranolol is a non-selective beta-blocker that can potentially cause bronchoconstriction in clients with asthma due to its beta-2 antagonistic effects. The nurse should clarify the prescription with the provider for this client to avoid exacerbating respiratory issues. Choices B, C, and D are not contraindications for propranolol administration, as hypertension, migraines, and stable angina are conditions that can be treated with beta-blockers. It is important for the nurse to assess each client's medical history and consider potential contraindications before administering medications to ensure client safety and optimal outcomes.