Nokea
An adult comes to the clinic with complaints of frequency and burning on urination. The nurse expects that what test will be ordered for the client?
- A. Clean catch urine for culture and sensitivity
- B. CBC and electrolytes
- C. Cystoscopy
- D. Strain of all urine for calculi
Correct Answer: A
Rationale: Frequency and burning suggest urinary tract infection; a clean catch urine culture identifies the causative organism and antibiotic sensitivity. CBC, cystoscopy, or straining are less immediate.
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The nurse is planning a client care conference with the parents of a 3-year-old with newly diagnosed type 1 diabetes mellitus. What is the priority outcome for the caregivers?
- A. Demonstrating adequate coping skills
- B. Knowing how to keep blood sugars stable
- C. Understanding how to perform meal planning
- D. Understanding the need for periodic follow-up visits
Correct Answer: B
Rationale: The priority outcome for caregivers of a child with type 1 diabetes is knowing how to keep blood sugars stable , as this directly impacts the child's health and prevents complications. Coping , meal planning , and follow-up are important but secondary.
A nurse is participating in an obstetrical emergency simulation in which the health care provider announces shoulder dystocia. Which of the following interventions should the assisting nurse implement? Select all that apply.
- A. Perform fundal massage
- B. Document the exact time of events
- C. Flex the client's legs back against the abdomen
- D. Request immediate assistance from other nurses
- E. Apply downward pressure above the client's symphysis pubis
Correct Answer: B,C,D,E
Rationale: For shoulder dystocia: document timing for accuracy, flex legs for McRoberts maneuver, request help for additional support, and apply suprapubic pressure to dislodge the shoulder. Fundal massage is for postpartum hemorrhage.
The nurse on a pediatric unit is caring for a preschooler who exhibits separation anxiety when the parents go to work. Which interventions should the nurse implement? Select all that apply.
- A. Encourage the parents to leave the child's favorite stuffed animal
- B. Establish a daily schedule similar to the child's home routine
- C. Give the child time to calm down alone when visibly upset
- D. Provide frequent opportunities for play and activity
- E. Remove visual reminders of the parents from the room
Correct Answer: A,B,D
Rationale: To manage separation anxiety: a stuffed animal provides comfort, a familiar schedule offers stability, and play distracts and engages. Isolating the child may worsen anxiety, and removing parental reminders could increase distress.
Laboratory Reference Ranges
Glucose – Fasting
70–110 mg/dL
(3.9–6.1 mmol/L)
A client with type 1 diabetes is prescribed NPH insulin before breakfast and dinner. Although the client reports feeling well, the 6 AM fasting blood glucose is 60 mg/dL. Which action should the nurse recommend to the client?
- A. Collect urine sample to check for urine ketones
- B. Consume a snack of milk and cereal at bedtime
- C. Increase carbohydrate intake at each meal
- D. Take only the prebreakfast dose of NPH
Correct Answer: B
Rationale: A fasting blood glucose of 60 mg/dL indicates hypoglycemia risk with NPH insulin, which peaks overnight. A bedtime snack prevents nocturnal hypoglycemia. Ketones are checked for hyperglycemia, increased carbohydrates may cause hyperglycemia, and skipping doses disrupts control.
It is the first day on the job for the newly hired unlicensed assistive personnel (UAP). Which of these illustrate appropriate assignment instructions for the licensed practical nurse (LPN) to give the UAP? Select all that apply.
- A. Elevate the right leg on two pillows.'
- B. Measure client for compression stockings.'
- C. Please let me know what the urine looks like.'
- D. Tell me what the client eats at lunch.'
- E. Verify wrist restraints are on correctly.'
Correct Answer: A,C,D
Rationale: Appropriate UAP tasks include elevating a leg , observing urine appearance , and reporting food intake . Measuring for stockings and verifying restraints require nursing judgment.