Nokea
The importance of monitoring blood sugar, activity level, and insulin doses is to
adjust the activity level based on the blood sugar level.
- A. adjust the diet and insulin doses as the activity level increases or decreases.
- B. adjust the diet and activity level based on the blood sugar level.
- C. adjust the insulin doses based on the sugar level in the urine.
Correct Answer: B
Rationale: If a patient injects too much insulin, exercises too much in relation to carbohydrate consumed, or does not eat enough or at the appropriate times, the blood glucose level can fall low enough to cause hypoglycemia. Adjusting diet and insulin doses based on activity level helps maintain balance.
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The school nurse is teaching a group of preschool mothers about poison prevention in the home. Which of the following statements, if made by a mother to the nurse, indicates that further teaching is necessary?
- A. I should have a bottle of Ipecac for each of my children.'
- B. I should induce vomiting if my child swallows lighter fluid.'
- C. Giving my child water or milk may help dilute the poison.'
- D. Proper storage is the key to poison prevention in the home.'
Correct Answer: B
Rationale: Inducing vomiting after ingesting hydrocarbons like lighter fluid is contraindicated due to the risk of aspiration, which can cause severe lung damage. Choice A is correct (Ipecac dosing is appropriate), choice C is accurate (dilution can help), and choice D is true (locked storage prevents poisoning). Further teaching is needed for choice B.
Which of the following signs should the nurse be aware of on a patient who is taking prednisone?
Melena
- A. Hypoglycemia
- B. Hypekalemia
- C. Low platelet counts
Correct Answer: A
Rationale: Prednisone can cause gastrointestinal irritation, leading to melena, a sign of bleeding.
A client who had a total thyroidectomy this morning is to be admitted to the surgical floor. What should the nurse have readily available when the client arrives?
- A. Tracheostomy set
- B. Catheterization tray
- C. Sterile dressing set
- D. Ventilator
Correct Answer: A
Rationale: Thyroidectomy risks airway obstruction from swelling or hematoma; a tracheostomy set is essential for emergency airway management.
A patient is admitted to the surgical unit with a diagnosis of rule out intestinal obstruction. The nurse is preparing to insert a Salem sump NG tube as ordered. In which of the following positions would it be BEST for the nurse to place this patient during the procedure?
- A. Head of bed elevated 30°-45°.
- B. Head of bed elevated 60°-90°.
- C. Side-lying with head elevated 15°.
- D. Lying flat with head turned to the left side.
Correct Answer: B
Rationale: Positioning the patient with the head of the bed elevated 60°-90° (high Fowler’s position) facilitates swallowing and allows gravity to aid the passage of the nasogastric (NG) tube through the esophagus into the stomach. This position reduces the risk of aspiration and eases tube insertion. Lower elevations (30°-45°), side-lying, or flat positions do not optimize swallowing or tube advancement as effectively.
Following a small-bowel resection, a client develops fever and anemia. The surface surrounding the surgical wound is warm to the touch and necrotizing fasciitis is suspected. Another manifestation that would most suggest necrotizing fasciitis is:
- A. erythema
- B. leukocytosis
- C. pressurelike pain
- D. swelling
Correct Answer: C
Rationale: Severe pressurelike pain out of proportion to visible signs distinguishes necrotizing fasciitis from cellulitis. Erythema, leukocytosis, and swelling are present in both cellulitis and necrotizing fasciitis.