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A nurse is reinforcing teaching with a client who has gastroesophageal reflux disease (GERD) about minimizing the effects of reflux during sleep. Which of the following client statements indicates an understanding of the teaching?
- A. I can have 6 ounces of alcohol before bed to help me sleep.
- B. I will have a snack 1 hour before going to bed.
- C. I should elevate the head of the bed.
- D. I will sleep on my stomach with my head flat.
Correct Answer: C
Rationale: Elevating the head of the bed helps reduce acid reflux by keeping stomach acid from flowing back into the esophagus during sleep.
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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 preparing to administer levothyroxine 100 mcg PO daily. Available is levothyroxine 50 mcg tablets. 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: 2 tablets
Rationale: 100 mcg ÷ 50 mcg/tablet = 2 tablets. The nurse should administer 2 tablets.
A nurse is collecting data from a client who has systemic lupus erythematosus. Which of the following findings is the highest priority to report to the provider?
- A. Client reports feeling depressed.
- B. Joint pain in hands and knees.
- C. Dry, raised rash on the face.
- D. Presence of peripheral edema.
Correct Answer: D
Rationale: Peripheral edema is the highest priority as it may indicate kidney involvement, a serious SLE complication requiring immediate attention.
A nurse is preparing to administer levothyroxine 275 mcg PO to a client. The amount available is levothyroxine 137 mcg/tablet. How many tablets should the nurse administer?
- B. 1 tablet
- C. 3 tablets
- D. 4 tablets
Correct Answer: 2 tablets
Rationale: 275 mcg ÷ 137 mcg/tablet = 2.007 tablets, rounded to 2 tablets.
A nurse is reinforcing discharge teaching with a client who has osteoarthritis. Which of the following statements by the client indicates an understanding of the teaching?
- A. Osteoarthritis is caused by inflammation that affects both joints and other body tissues.
- B. Osteoarthritis occurs due to the aging process and results in disintegration of cartilage in a joint.
- C. Osteoarthritis is due to loss of calcium in the bones, which can lead to increased risk for bone fractures.
- D. Osteoarthritis happens in several phases when deposits of crystals develop in joints and soft tissues.
Correct Answer: B
Rationale: Osteoarthritis is a degenerative joint disease caused by aging and cartilage disintegration, as correctly stated.