Nokea
A woman who is pregnant develops gestational diabetes. The NP's initial action is to:
- A. prescribe an oral antidiabetic agent.
- B. give her information about diet and exercise.
- C. begin treating her with daily insulin injections.
- D. reassure her that her glucose levels will return to normal after pregnancy.
Correct Answer: B
Rationale: The correct answer is B because diet and exercise are the initial management for gestational diabetes. Choice A is incorrect (oral agents lack sufficient safety data). Choice C is wrong (insulin isn’t first-line). Choice D is inaccurate (reassurance alone doesn’t address current needs).
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What predisposing factor most likely contributed to the proximal end of the femur fracture in a 62-year-old woman who lives alone and tripped on a rug in her home?
- A. Failing eyesight leading to an unsafe environment
- B. Renal osteodystrophy from chronic kidney disease (CKD)
- C. Osteoporosis from declining hormone levels
- D. Cerebral vessel changes causing transient ischemic attacks
Correct Answer: C
Rationale: The most likely predisposing factor contributing to the proximal end of the femur fracture in a 62-year-old woman is osteoporosis resulting from declining hormone levels. Osteoporosis weakens the bones, making them more susceptible to fractures, especially in older adults, particularly women. In this case, the fracture can be attributed to the bone density loss associated with osteoporosis, which is a common concern in postmenopausal women. Choices A, B, and D are less likely to have directly contributed to the femur fracture in this scenario. Failing eyesight may increase the risk of falls but does not directly weaken the bones. Renal osteodystrophy affects bone health but is less common in this age group. Cerebral vessel changes causing transient ischemic attacks are related to vascular issues, not bone strength.
A client has a new prescription for docusate sodium. Which of the following instructions should be included in the discharge teaching?
- A. Take the medication with a full glass of water.
- B. Take the medication at bedtime.
- C. Take the medication on an empty stomach.
- D. Avoid taking the medication with antacids.
Correct Answer: A
Rationale: Corrected Rationale: When taking docusate sodium, it is important to take the medication with a full glass of water to help ensure its proper effectiveness. This helps prevent the stool from hardening and makes it easier to pass, especially for individuals experiencing constipation. Choice B is incorrect because there is no specific instruction to take docusate sodium at bedtime. Choice C is incorrect because docusate sodium does not need to be taken on an empty stomach. Choice D is incorrect because there is no need to avoid taking docusate sodium with antacids.
A client with a history of chronic heart failure is being discharged. Which instruction should the nurse include in the discharge teaching?
- A. Weigh yourself daily and report a weight gain of 2 pounds or more in a day.
- B. Restrict fluid intake to 2000 mL per day.
- C. Increase your salt intake to prevent electrolyte imbalance.
- D. Exercise vigorously at least three times a week.
Correct Answer: A
Rationale: The correct answer is to weigh yourself daily and report a weight gain of 2 pounds or more in a day. This instruction is crucial because daily weights help in early detection of fluid retention, a common complication in heart failure. Monitoring weight is essential for managing heart failure and preventing exacerbations. Choice B is incorrect because fluid restriction may be necessary in some cases of heart failure, but a general limit of 2000 mL per day is not appropriate without individual assessment. Choice C is incorrect as increasing salt intake can worsen fluid retention and exacerbate heart failure symptoms. Choice D is incorrect because while exercise is beneficial for heart health, vigorous exercise may not be suitable for all heart failure patients and should be tailored to their specific condition.
An 81-year-old male client has emphysema. He lives at home with his cat and manages self-care with no difficulty. When making a home visit, the nurse notices that this client's tongue is somewhat cracked, and his eyeballs appear sunken into his head. Which nursing intervention is indicated?
- A. Help the client determine ways to increase his fluid intake.
- B. Obtain an appointment for the client to have an eye examination.
- C. Instruct the client to use oxygen at night and increase humidification.
- D. Schedule the client for tests to determine his sensitivity to cat hair.
Correct Answer: A
Rationale: The client's cracked tongue and sunken eyes indicate dehydration. Therefore, the priority nursing intervention is to help the client determine ways to increase his fluid intake. Dehydration can exacerbate the client's emphysema symptoms and lead to further complications. Monitoring and addressing the client's fluid intake is crucial for maintaining his health and well-being. Options B, C, and D are not the immediate priorities in this situation. While an eye examination, oxygen use, and sensitivity tests are relevant aspects of care, addressing dehydration through increased fluid intake takes precedence in this scenario.
Differences between brand-name drugs and their generic equivalents include:
- A. Active ingredient
- B. Cost
- C. Color of the tablet
- D. All of the above
Correct Answer: B
Rationale: Choice B is correct because generics have the same active ingredient as brand-name drugs but typically cost less, per FDA bioequivalence rules. Choice A is incorrect as active ingredients are identical. Choice C is wrong because color may differ but isn't a functional difference. Choice D is incorrect since only cost is a consistent distinction.