Nokea
A nurse is preparing to administer hydrochlorothiazide 25 mg PO. The amount available is hydrochlorothiazide 50 mg/tablet. How many tablets should the nurse administer? (Round the answer to the nearest whole number. Use a leading zero if it applies. (Do not use a trailing zero))
Correct Answer: 1 tablet
Rationale: 25 mg ÷ 50 mg/tablet = 0.5 tablets, but since tablets cannot be split without specific instructions, the nurse should administer 1 tablet as per standard practice.
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A nurse is providing care for an older adult client who has hyperglycemia, polydipsia, and polyuria. Which of the following manifestations supports the clinical presentation of hyperosmolar hyperglycemic syndrome (HHS)? (Select All that Apply.)
- A. Acetone breath.
- B. Fever.
- C. Serum glucose 800 mg/dL (74 to 106 mg/dL).
- D. Serum bicarbonate 15 mEq/L (21 to 28 mEq/L).
- E. Insidious onset.
Correct Answer: B,C,E
Rationale: Fever, serum glucose of 800 mg/dL, and insidious onset are characteristic of HHS, often triggered by infection and marked by extreme hyperglycemia without significant ketoacidosis.
A nurse is assessing an older adult client who has a urinary tract infection (UTI). Which of the following findings should the nurse identify as unique for this age group?
- A. Confusion.
- B. Urinary retention.
- C. Incontinence.
- D. Low back pain.
Correct Answer: A
Rationale: Confusion is a unique symptom of urinary tract infections (UTIs) in older adults, often being the first or only symptom, making it a critical indicator for this age group.
A nurse is caring for a client who is experiencing an acute exacerbation of ulcerative colitis. The nurse should recognize that which of the following actions is the priority?
- A. Review stress factors that can cause disease exacerbation.
- B. Evaluate fluid and electrolyte levels.
- C. Promote physical mobility.
- D. Provide emotional support.
Correct Answer: B
Rationale: Evaluating fluid and electrolyte levels is the priority due to significant fluid loss and electrolyte imbalances during an acute exacerbation of ulcerative colitis.
A nurse is collecting data from a client who has peripheral arterial disease (PAD). Which of the following findings should the nurse expect?
- A. Warm extremities.
- B. Darkened skin color near extremities.
- C. Intermittent claudication.
- D. Edema.
Correct Answer: C
Rationale: Intermittent claudication, pain or cramping in the legs during exercise that subsides with rest, is a hallmark symptom of PAD due to reduced blood flow.
A nurse is assisting with the care of a client immediately following a lumbar puncture. Which of the following actions should the nurse take? (Select all that apply.)
- A. Monitor the puncture site for hematoma.
- B. Elevate the client's head of bed.
- C. Insert a urinary catheter.
- D. Encourage fluid intake.
- E. Apply a cervical collar to the client.
Correct Answer: A,D
Rationale: Monitoring the puncture site for hematoma and encouraging fluid intake are crucial to detect complications and replenish cerebrospinal fluid, reducing the risk of post-lumbar puncture headache.