Mrs. M has had diabetes for seven years. She has worked hard to control her blood glucose levels and watch her dietary intake. Her physician orders a hemoglobin A1C test. Which of the following best describes the action of this test?
- A. The test determines if the client is anemic and needs iron supplements
- B. The test determines if there is excess glucose building up in the urine
- C. The test determines the amount of hemoglobin reaching the liver to support gluconeogenesis
- D. The test determines the amount of hemoglobin that is coated with glucose
Correct Answer: D
Rationale: A hemoglobin A1C test, also known as a glycated hemoglobin test, determines the amount of hemoglobin that is coated with glucose. Excess glucose in the bloodstream may cause it to attach to hemoglobin on red blood cells. Because the life of these cells is between 2 and 3 months, the hemoglobin A1C is an accurate measurement of a client's glucose during that time. Choices A, B, and C are incorrect. Choice A relates to anemia and iron supplements, which are not assessed by a hemoglobin A1C test. Choice B mentions excess glucose in the urine, which is typically assessed through a urine glucose test, not the hemoglobin A1C test. Choice C is incorrect as the test is not related to the amount of hemoglobin reaching the liver to support gluconeogenesis; instead, it specifically measures the amount of hemoglobin that is glycated or coated with glucose.
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The nurse is teaching a smoking cessation program. He will state that which of the following benefits of quitting appear within one year?
- A. risk of coronary heart disease is the same as that of a nonsmoker
- B. carbon monoxide level in blood drops to normal
- C. risk of dying from lung cancer is about half that of a smoker's
- D. risk of having a stroke is reduced to that of a nonsmoker's
Correct Answer: B
Rationale: Within 24 hours of quitting smoking, carbon monoxide levels drop to normal. Other benefits (A, C, D) take longer (5-15 years for heart disease, 10 years for lung cancer, 5-10 years for stroke risk). Thus, B is the correct benefit within one year.
The nurse is caring for a client with a non-rebreather mask. Which is the priority nursing action when caring for this client?
- A. maintain the mask snugly on the face
- B. adjust flow rate to keep the reservoir bag inflated
- C. ensure that the reservoir bag is not kinked or twisted
- D. ensure that valves open during expiration and close on inhalation
Correct Answer: B
Rationale: Adjusting the flow rate to keep the reservoir bag inflated ensures adequate oxygen delivery, the primary goal of a non-rebreather mask.
A client has been started on a monoamine oxidase inhibitor (MAOI). Which information should the nurse include when teaching the client about the medication?
- A. This medication can cause severe drowsiness.
- B. The client must avoid foods that contain tyramine.
- C. The medication is associated with a high rate of abuse.
- D. The medication will begin to alleviate symptoms of depression almost immediately.
Correct Answer: B
Rationale: MAOIs are used to treat depression. Although MAOIs usually produce hypotension as a side effect, potentially lethal hypertension can occur if the client eats foods that contain tyramine. Such foods include aged cheeses, hot dogs, and beer, among others. The medication does not cause drowsiness, is not associated with a high rate of abuse, and does not act almost immediately.
The nurse has completed giving medication instructions to a client receiving benazepril to treat hypertension. Which statement made by the client indicates to the nurse that the client needs further teaching?
- A. I need to change positions slowly.
- B. I need to monitor my blood pressure every week.
- C. I need to use salt moderately in cooking and on foods.
- D. I need to report signs and symptoms of infection to my doctor.
Correct Answer: D
Rationale: Benazepril is an angiotensin-converting enzyme (ACE) inhibitor used to treat hypertension. Client education includes changing positions slowly to avoid orthostatic hypotension, monitoring blood pressure regularly, and using salt moderately as part of a heart-healthy diet. However, reporting signs and symptoms of infection is not directly related to benazepril use, as infections are not a common side effect. The client may need further teaching to clarify the specific side effects to monitor, such as cough, swelling, or signs of hyperkalemia.
A client diagnosed with acquired immunodeficiency syndrome (AIDS) gets recurrent Candida infections of the mouth (thrush). The nurse has given the client instructions to minimize the occurrence of thrush and determines that the client understands the instructions if which statement is made by the client?
- A. I should use a mouthwash at least once a week.
- B. I should use warm saline or water to rinse my mouth.
- C. I should brush my teeth and rinse my mouth once a day.
- D. Increasing the amount of red meat in my diet will keep this from recurring.
Correct Answer: B
Rationale: To minimize the occurrence of oral thrush in a client with AIDS, maintaining good oral hygiene is essential. Rinsing the mouth with warm saline or water helps keep the oral cavity clean and reduces the risk of Candida overgrowth. Using mouthwash once a week is insufficient, and brushing only once a day does not provide adequate oral hygiene. Increasing red meat intake does not directly affect thrush prevention, as dietary changes unrelated to sugar or carbohydrate reduction have little impact on Candida infections.
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