Nokea
Nurse Raymond is giving instructions to an elderly client on diabetic foot care. Which teaching is not part of foot care?
- A. wear comfortable shoes that fit well and protect your feet
- B. trim your toenails straight across and file edges with emery board
- C. wash your feet in hot water to keep feet soft
- D. wear shoes at the beach or on hot pavement
Correct Answer: C
Rationale: The correct answer is C because washing feet in hot water can lead to burns or skin damage for those with diabetes. A: Proper footwear is essential for preventing foot injuries. B: Trimming toenails straight across helps prevent ingrown nails. D: Wearing shoes on hot surfaces prevents burns or blisters. Overall, C is incorrect due to the potential harm it can cause to diabetic feet.
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A client with Addison’s disease comes to the clinic for a follow-up visit. When assessing this client, the nurse should stay alert for signs and symptoms of:
- A. calcium and phosphorus abnormalities
- B. sodium and chloride abnormalities
- C. chloride and magnesium
- D. sodium and potassium abnormalities abnormalities.
Correct Answer: D
Rationale: The correct answer is D. In Addison's disease, the adrenal glands do not produce enough cortisol and aldosterone. This leads to sodium and potassium imbalances. Low aldosterone causes sodium loss and potassium retention, resulting in sodium and potassium abnormalities. The other choices, A, B, and C, do not directly relate to Addison's disease. Calcium and phosphorus abnormalities are not typically associated with Addison's disease. Sodium and chloride, and chloride and magnesium imbalances are not primary concerns in Addison's disease. Therefore, staying alert for signs and symptoms of sodium and potassium abnormalities is crucial in managing and monitoring a client with Addison's disease.
The nurse understands that which of the ff. best describes the action of propanolol (Inderal)?
- A. It increases heart rate
- B. It decreases fluid volume
- C. It decreases cardiac output
- D. It increases cardiac contractility
Correct Answer: C
Rationale: Step-by-step rationale:
1. Propranolol is a beta-blocker that acts on the heart.
2. It blocks beta-adrenergic receptors, leading to decreased heart rate and contractility.
3. Decreased heart rate and contractility result in reduced cardiac output.
4. Therefore, the correct answer is C - It decreases cardiac output.
Summary: A, B, and D are incorrect because propranolol does not increase heart rate, fluid volume, or cardiac contractility.
Which of the following is disease process characterized by a chronic progressive inflammation of the sacroiliac and costovertebral joints and adjacent soft tissue?
- A. Rheumatoid arthritis
- B. Scoliosis
- C. Kyphosis
- D. Ankylosing spondylitis
Correct Answer: D
Rationale: The correct answer is D: Ankylosing spondylitis. This disease process is characterized by chronic progressive inflammation of the sacroiliac and costovertebral joints and adjacent soft tissue. Ankylosing spondylitis specifically affects the spine and large joints. Rheumatoid arthritis (A) is characterized by joint inflammation and primarily affects small joints. Scoliosis (B) is a condition characterized by an abnormal lateral curvature of the spine, not inflammation of the sacroiliac and costovertebral joints. Kyphosis (C) is an excessive outward curvature of the spine, not related to inflammation of the sacroiliac and costovertebral joints.
Which of the following blood types would the nurse identify as the rarest?
- A. A
- B. AB
- C. B
- D. O
Correct Answer: B
Rationale: The correct answer is B (AB). AB blood type is the rarest because it is a result of inheriting both A and B alleles, making it less common in the population. AB individuals can only receive blood from other AB individuals due to their unique antigens. Blood types A, B, and O are more common in the population, with O being the most common as it is the universal donor. Blood type A and B are more common than AB since they only require one allele for their respective antigens. Thus, the rarity of AB blood type is due to the inheritance of both A and B alleles, making it the least common among the choices provided.
Mrs. Zeno continues to become a weaker despite .treatment with neostigmine. Edrophonium HCL is ordered:
- A. For its synergestic effect
- B. Because of the client's resistance to
- C. To rule out cholinergic crisis Neostigmine
- D. To confirm the diagnosis of myasthenia
Correct Answer: C
Rationale: The correct answer is C: To rule out cholinergic crisis caused by Neostigmine. Edrophonium HCL is a fast-acting cholinesterase inhibitor used to differentiate between myasthenic crisis and cholinergic crisis. If the patient's weakness improves after administration of edrophonium, it indicates that the weakness was due to myasthenia gravis and not cholinergic crisis caused by excessive neostigmine. Choice A is incorrect because there is no synergestic effect between neostigmine and edrophonium. Choice B is incorrect as resistance to neostigmine is not a valid reason for ordering edrophonium. Choice D is incorrect because edrophonium is used for differential diagnosis, not for confirming the diagnosis of myasthenia gravis.