Nokea
A young adult has been diagnosed with Type 1 diabetes mellitus. The client asks how his condition differs from that of his grandmother who has Type 2 diabetes mellitus. What should the nurse include when replying?
- A. In Type 1 diabetes, the pancreas does not secrete enough insulin; in Type 2 diabetes, the cells are not able to pick up insulin.
- B. Type 1 diabetes is always treated with insulin; Type 2 diabetes is never treated with insulin.
- C. Type 1 diabetes comes before Type 2 diabetes. The client will develop Type 2 diabetes as he ages.
- D. Type 1 diabetes is a result of overindulgence of sweets; Type 2 diabetes is related to overindulgence of fats.
Correct Answer: A
Rationale: Type 1 diabetes involves autoimmune destruction of pancreatic beta cells, causing insulin deficiency; Type 2 involves insulin resistance. Insulin may be used in Type 2, and diet or progression are not defining factors.
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When walking past a client's room, the nurse hears 1 unlicensed assistive personnel (UAP) talking to another UAP. Which statement requires follow-up intervention?
- A. If we work together we can get all of the client care completed.
- B. Since I am late for lunch, would you do this one client's glucose test?
- C. If we client seems confused, we need to watch another closely.
- D. I'll come back and make the bed after I go to the lab.
Correct Answer: B
Rationale: Only the RN and PN can delegate to UAPs. One UAP cannot delegate a task to another UAP. The RN or PN is legally accountable for the nursing care.
A client has been admitted with a fractured femur and has been placed in skeletal traction. Which of the following nursing interventions should receive priority?
- A. Maintaining proper body alignment
- B. Frequent neurovascular assessments of the affected leg
- C. Inspection of pin sites for evidence of drainage or inflammation
- D. Applying an over-bed trapeze to assist the client with movement in bed
Correct Answer: B
Rationale: The most important activity for the nurse is to assess neurovascular status. Compartment syndrome is a serious complication of fractures. Prompt recognition of this neurovascular problem and early intervention may prevent permanent limb damage.
The client is receiving a gentamicin IV. Which finding may indicate an adverse response to gentamicin?
- A. Decreased urine output
- B. Blurred vision
- C. Orange sputum
- D. Hypertension
Correct Answer: A
Rationale: Gentamicin is nephrotoxic; decreased urine output suggests kidney injury, a serious adverse effect. Other symptoms are not typically associated.
Laboratory reference ranges
Hemoglobin
Male: 14.0–18.0 g/dL
(140–180 g/L)
Female: 12.0–16.0 g/dL
(120–160 g/L)
WBC
5000–10,000/mm³
(5–10 × 10⁹/L)
The nurse is collecting data from a client with acute diverticulitis. Which of the following findings would be essential to follow up?
- A. abdominal pain has progressed to the left upper quadrant
- B. hemoglobin of 11.2 g/dL (112 g/L)
- C. lying on side with knees drawn up to abdomen and trunk flexed
- D. WBC count of 12,000/mm³ (12 x 10â¹/L)
Correct Answer: A
Rationale: Pain progressing to the left upper quadrant in diverticulitis is concerning for complications like perforation or abscess, requiring follow-up. Mild anemia and flexed positioning are common, and a moderately elevated WBC is expected in acute inflammation.
The charge nurse on a cardiac unit tells you a patient is exhibiting signs of right-sided heart failure. Which of the following would not indicate right-sided heart failure?
- A. Nausea
- B. Anorexia
- C. Rapid weight gain
- D. SOB (shortness of breath)
Correct Answer: D
Rationale: Left sided heart failure exhibits signs of pulmonary compromise (SOB).