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A nurse is caring for a patient who is receiving total parenteral nutrition (TPN). Which of the following laboratory values should the nurse monitor? Which lab value should the nurse monitor for TPN?
- A. Serum glucose
- B. Serum calcium
- C. Serum magnesium
- D. Serum sodium
Correct Answer: A
Rationale: The correct answer is A: Serum glucose. When a patient is receiving TPN, monitoring serum glucose levels is crucial as TPN solutions contain high concentrations of glucose. Elevated glucose levels can lead to hyperglycemia, which can result in complications such as osmotic diuresis and hyperosmolar hyperglycemic state. Monitoring glucose levels helps in adjusting TPN infusion rates to maintain a stable blood glucose level.
Incorrect answers:
B: Serum calcium - Calcium levels are not directly affected by TPN and are not typically monitored specifically for patients receiving TPN.
C: Serum magnesium - While magnesium levels may be affected by TPN, glucose monitoring is more critical due to the high glucose content in TPN.
D: Serum sodium - Sodium levels are not directly influenced by TPN and are not typically monitored specifically for patients receiving TPN.
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A nurse is caring for a patient who is postoperative following a thyroidectomy. Which of the following findings should the nurse monitor for? Which finding should the nurse monitor post-thyroidectomy?
- A. Hypotension
- B. Tachycardia
- C. Hyperglycemia
- D. Bradypnea
Correct Answer: B
Rationale: The correct answer is B: Tachycardia. Following a thyroidectomy, the nurse should monitor for tachycardia due to the risk of thyroid storm, which can cause increased heart rate. Hypotension (A) is less common post-thyroidectomy. Hyperglycemia (C) is not a typical finding post-thyroidectomy. Bradypnea (D) is not expected, as respiratory rate should be monitored for signs of airway obstruction.
A nurse is caring for a client who has nausea and a prescription for metoclopramide intravenously every 8 hours as needed. The client asks the nurse how metoclopramide will relieve her nausea. Which explanation should the nurse provide?How does metoclopramide relieve nausea?
- A. The medication relieves nausea by promoting gastric emptying.
- B. The medication works by relaxing gastric muscles.
- C. The medication works by decreasing gastric acid secretions.
- D. The medication enhances gastric emptying.
Correct Answer: A,D
Rationale: The correct answers are A and D. Metoclopramide relieves nausea by promoting gastric emptying, which helps move food through the stomach faster. This action reduces the feeling of fullness and discomfort, ultimately alleviating nausea. Additionally, enhancing gastric emptying helps prevent reflux, which can contribute to nausea. Choices B and C are incorrect because metoclopramide does not work by relaxing gastric muscles or decreasing gastric acid secretions. These mechanisms do not directly address the issue of delayed gastric emptying, which is the primary reason for nausea relief with metoclopramide.
Nurses’ Notes at 0700hrs
The client appears fatigued and reports a persistent headache. He has been experiencing muscle aches throughout his body. He also complains of a sore throat and has had a fever for the past two days. The client’s skin is warm to the touch and he appears slightly dehydrated.
Vital Signs at 0700hrs
• Temperature: 39.5°C (103.1°F)
• Blood pressure: 128/56 mm Hg
• Heart rate: 112/min
• Respiratory rate: 22/min
• SaO2: 96% on room air
Diagnostic Results at 0700hrs
• Complete blood count shows elevated white blood cells
• Throat culture has been sent to the lab for analysis
• Chest X-ray pending
A nurse is caring for a 45-year-old male client in the emergency department. The client was admitted at 0700hrs with a 2-day history of headache, muscle aches, fever, sore throat, and fatigue.The nurse is preparing to administer an antibiotic to the client. Which of the following actions should the nurse take? (Select all that apply)
- A. Wear a mask when caring for the client.
- B. Encourage the client to increase fluid intake.
- C. Place the client in a private room.
- D. Place the client on contact precautions.
- E. Monitor the client's temperature every 4 hours.
- F. Check the client's allergy history before administering the antibiotic.
- G. Educate the client about the importance of completing the full course of antibiotics.
Correct Answer: B,E,F,G
Rationale: The correct actions the nurse should take are to encourage the client to increase fluid intake, monitor the client's temperature every 4 hours, check the client's allergy history before administering the antibiotic, and educate the client about the importance of completing the full course of antibiotics.
Encouraging fluid intake helps maintain hydration and aids in the body's recovery. Monitoring temperature helps assess the client's response to treatment. Checking allergy history is crucial to prevent adverse reactions. Educating the client about completing the full course of antibiotics ensures effective treatment and prevents antibiotic resistance.
Wearing a mask (choice A) is not necessary for this situation unless the client is suspected of having a contagious respiratory illness. Placing the client in a private room (choice C) and placing the client on contact precautions (choice D) are not indicated unless the client is diagnosed with a specific contagious infection, which is not mentioned in the scenario.
A nurse has accepted a position on a pediatric unit and is learning about psychosocial development. Arrange Erikson's stages of psychosocial development in order from birth to adolescence. Arrange Erikson's stages from birth to adolescence.
- A. Identity vs. role confusion
- B. Trust vs. mistrust
- C. Industry vs. inferiority
- D. Autonomy vs. shame and doubt
- E. Initiative vs. guilt
Correct Answer: B,D,E,C,A
Rationale: 1. Trust vs. mistrust comes first as it pertains to infancy and the development of basic trust in caregivers.
2. Autonomy vs. shame and doubt follows, focusing on toddlers developing independence.
3. Initiative vs. guilt is next, focusing on preschoolers exploring and taking initiative.
4. Industry vs. inferiority is about school-aged children developing competence.
5. Identity vs. role confusion is about adolescents forming a sense of self.
Therefore, the correct order is B, D, E, C, A. Other choices are incorrect as they do not align with the chronological order of Erikson's stages.
A nurse in the emergency department is attending to a patient exhibiting symptoms of a myocardial infarction. Which of the following actions should the nurse prioritize? Which action should the nurse prioritize for myocardial infarction?
- A. Initiate oxygen therapy.
- B. Obtain a blood sample.
- C. Attach the leads for a 12-lead ECG.
- D. Insert an IV catheter.
Correct Answer: A
Rationale: The correct answer is A: Initiate oxygen therapy. In a myocardial infarction, the priority is to ensure adequate oxygen supply to the heart muscle to prevent further damage. Oxygen therapy helps increase oxygen delivery to the heart, reducing the workload on the heart muscle. This action can potentially limit the size of the infarction and improve the patient's outcome. Obtaining a blood sample (B) can provide valuable information but is not as urgent as ensuring oxygen supply. Attaching leads for a 12-lead ECG (C) is important for diagnosing the myocardial infarction but does not directly address the immediate need for oxygen. Inserting an IV catheter (D) may be necessary for administering medications, but oxygen therapy takes precedence in this situation.