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A patient with diabetes mellitus presents with polyuria, polydipsia, nocturia, and fatigue. Laboratory findings reveal hyperglycemia, glycosuria, and ketonuria. What is the most likely diagnosis?
- A. Diabetic nephropathy
- B. Diabetic ketoacidosis (DKA)
- C. Hyperosmolar hyperglycemic state (HHS)
- D. Diabetic autonomic neuropathy
Correct Answer: B
Rationale: The presentation of a patient with diabetes mellitus showing symptoms of polyuria, polydipsia, nocturia, and fatigue along with laboratory findings of hyperglycemia, glycosuria, and ketonuria is indicative of diabetic ketoacidosis (DKA). DKA is a serious complication of diabetes characterized by hyperglycemia, metabolic acidosis, and ketosis. The increased glucose levels lead to glycosuria, causing osmotic diuresis resulting in polyuria, polydipsia, and nocturia. The body starts breaking down fats for energy in the absence of sufficient insulin, leading to the production of ketones causing ketonuria. The patient may also experience fatigue due to the metabolic abnormalities present in DKA.
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A patient with a history of heart failure is prescribed a beta-blocker. Which assessment finding indicates a therapeutic effect of beta-blocker therapy?
- A. Decreased heart rate
- B. Increased blood pressure
- C. Elevated respiratory rate
- D. Worsening dyspnea Pharmacology
Correct Answer: A
Rationale: Beta-blockers are medications commonly used in the management of heart failure. One of the therapeutic effects of beta-blockers is to decrease the heart rate. By blocking the action of adrenaline on the heart, beta-blockers help to slow down the heart rate, reduce the workload on the heart, and improve overall heart function. In patients with heart failure, a decreased heart rate is a favorable outcome as it can help improve cardiac output and reduce symptoms of heart failure such as fatigue and shortness of breath. Monitoring the heart rate is an important assessment parameter to evaluate the effectiveness of beta-blocker therapy in patients with heart failure. Therefore, a decreased heart rate would indicate a therapeutic effect of beta-blocker therapy in this patient.
Which of the following conditions is characterized by an abnormal enlargement of the prostate gland, leading to lower urinary tract symptoms such as urinary hesitancy, weak urinary stream, and incomplete bladder emptying?
- A. Prostate cancer
- B. Benign prostatic hyperplasia (BPH)
- C. Prostatitis
- D. Prostate adenoma
Correct Answer: B
Rationale: Benign prostatic hyperplasia (BPH) is a condition characterized by an abnormal enlargement of the prostate gland, which is non-cancerous. This enlargement can lead to lower urinary tract symptoms such as urinary hesitancy (difficulty starting the urine stream), weak urinary stream, incomplete bladder emptying, frequent urination, urgency, and nocturia. BPH is a common condition in aging men and is not usually associated with prostate cancer. Other conditions like prostate cancer, prostatitis, and prostate adenoma may present with similar symptoms, but BPH is specifically characterized by the non-cancerous enlargement of the prostate gland. Treatment for BPH may include medications to improve symptoms or surgical procedures to reduce the size of the prostate gland.
The nurse ensures, which of the following should be present and be cooperative in the educational program?
- A. Patient, student nurses and interns
- B. Patient, family and significant others
- C. Head nurse and family
- D. New staff nurses and nursing aides of the unit
Correct Answer: B
Rationale: In an educational program conducted by a nurse, it is crucial to involve the patient, their family, and significant others. This approach ensures holistic care by considering the patient's psychosocial environment, family dynamics, and support system. Including these individuals in the educational program fosters collaboration, strengthens the patient-nurse relationship, and equips family members with the knowledge and skills needed to provide optimal care at home. Furthermore, involving the patient's support system can enhance adherence to treatment plans and contribute to better health outcomes. Therefore, the presence and cooperation of the patient, family, and significant others are essential elements of a successful educational program led by a nurse.
After a throurough assessment by the physician-specialist, an order for an immediate sonogram was made specific for the medical condition?
- A. Operation Room
- B. Intervention
- C. Laboratory
- D. CT Scan
Correct Answer: B
Rationale: In this scenario, the physician-specialist assessed the patient and determined that an immediate sonogram is needed for the medical condition. An intervention is a specific action taken in response to a medical need or condition. Ordering an immediate sonogram falls under the category of an intervention because it involves a timely and targeted diagnostic procedure to address the medical situation identified by the physician. The other options (A. Operation Room, C. Laboratory, D. CT scan) do not accurately represent the specific action of ordering a sonogram in response to the medical condition assessed by the physician.
A postpartum client who delivered a macrosomic infant expresses concerns about breastfeeding difficulties due to the baby's size. What nursing intervention should be prioritized to support successful breastfeeding in this situation?
- A. Providing education on techniques to improve latch and milk transfer
- B. Recommending supplemental formula feedings to ensure adequate nutrition
- C. Encouraging the client to avoid breastfeeding to prevent discomfort
- D. Referring the client to a lactation consultant for specialized support
Correct Answer: A
Rationale: Providing education on techniques to improve latch and milk transfer should be prioritized to support successful breastfeeding in this situation. Newborns who are macrosomic (large for gestational age) may have difficulties latching due to their size and may require additional support to effectively breastfeed. By educating the postpartum client on proper latch techniques and milk transfer, the nurse can help optimize the breastfeeding experience for both the mother and baby. This intervention focuses on addressing the specific concerns related to the infant's size and aims to promote successful breastfeeding despite potential challenges. As such, recommending supplemental formula feedings, encouraging the client to avoid breastfeeding, or immediately referring to a lactation consultant may not directly address the immediate need for support in improving breastfeeding in this situation.