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Serge, who has diabetes mellitus, is taking oral agents and is scheduled for a diagnostic test that requires him to be NPO. What is the best plan of action for the nurse regarding Serge's oral medications?
- A. Administer the oral agents immediately after the test.
- B. Notify the diagnostic department and request orders.
- C. Notify the physician and request orders.
- D. Administer the oral agents with a sip of water before the test.
Correct Answer: C
Rationale: The best plan of action for the nurse is to notify the physician and request orders regarding Serge's oral medications. By involving the physician, the nurse ensures that appropriate instructions are obtained, considering Serge's medical condition and the need for NPO status for the diagnostic test. Administering the medications without medical guidance (choice A) can be risky, as it may affect the test results. Notifying the diagnostic department (choice B) is not the most direct and appropriate action; the physician is the primary healthcare provider responsible for medication orders. Administering the medications with water before the test (choice D) is not advisable when the patient is supposed to be NPO, as it can interfere with the test requirements.
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What is the most common cause of HHNS?
- A. Insulin overdose
- B. Removal of the adrenal gland
- C. Undiagnosed, untreated hyperpituitarism
- D. Undiagnosed, untreated diabetes mellitus
Correct Answer: D
Rationale: The correct answer is D: Undiagnosed, untreated diabetes mellitus. Hyperosmolar hyperglycemic nonketotic syndrome (HHNS) is most commonly caused by undiagnosed and untreated diabetes mellitus. Insulin overdose (Choice A) is not a typical cause of HHNS; it is more related to hypoglycemia. Removal of the adrenal gland (Choice B) can lead to adrenal insufficiency but is not a common cause of HHNS. Undiagnosed, untreated hyperpituitarism (Choice C) is not a usual cause of HHNS; it is more related to pituitary hormone imbalances rather than hyperglycemia.
A nurse in a clinic is reviewing laboratory reports for a group of clients. Which of the following diseases should the nurse report to the state health department?
- A. Pertussis
- B. Group B streptococcal disease
- C. Respiratory syncytial virus
- D. Rotavirus
Correct Answer: A
Rationale: Pertussis is the correct answer because it is a reportable disease that healthcare providers are required by law to report to public health authorities. This infectious disease poses a significant public health risk and needs to be monitored closely to prevent outbreaks and implement control measures. Group B streptococcal disease, Respiratory syncytial virus, and Rotavirus are important conditions but are not typically reportable to the state health department. These diseases may require specific precautions in healthcare settings, but they do not fall under mandatory reporting requirements.
A clinical instructor teaches a class for the public about diabetes mellitus. Which individual does the nurse assess as being at highest risk for developing diabetes?
- A. The 50-year-old client who does not engage in any physical exercise
- B. The 56-year-old client who drinks three glasses of wine daily
- C. The 42-year-old client who is 50 pounds overweight
- D. The 38-year-old client who smokes one pack of cigarettes daily
Correct Answer: C
Rationale: The 42-year-old client who is 50 pounds overweight is at the highest risk for developing diabetes. Excess weight is a significant risk factor for diabetes as it can lead to insulin resistance and metabolic abnormalities. Choices A, B, and D are also risk factors for diabetes, but being overweight has a stronger association with the development of the condition compared to lack of exercise, excessive alcohol consumption, or smoking.
A client with a tumor refuses surgery, but the client's partner wants it. Which is the deciding factor in determining if the surgery will be done?
- A. Whether the partner is the client's durable power of attorney for healthcare
- B. Whether the client understands the risk of refusing the procedure
- C. Whether the client's refusal is based on religious belief
- D. Whether the facility's ethical committee reaches a consensus on the case
Correct Answer: B
Rationale: The correct answer is B because the client's understanding of the risks involved in refusing the surgery is crucial in determining the course of action. In this scenario, the client's autonomy and decision-making capacity take precedence. Choice A is not directly relevant to the decision-making process regarding surgery. Choice C, religious beliefs, may influence the decision but should not be the determining factor in this case. Choice D involving the facility's ethical committee is not typically involved in individual patient care decisions.
You are caring for a patient who has no cognitive functioning but only basic human functions such as opening the eyes and the sleep-wake cycle. What level of consciousness does this patient have?
- A. Obtunded
- B. A persistent vegetative state
- C. Locked-in syndrome
- D. Brain death
Correct Answer: B
Rationale: A persistent vegetative state is characterized by the absence of cognitive functioning while basic human functions like the sleep-wake cycle are retained. In this state, the patient shows reflex movements and basic responses to stimuli but lacks awareness or higher mental functions. Choices A, C, and D are incorrect because:
A) Obtunded refers to a decreased level of consciousness, not the absence of cognitive functioning.
C) Locked-in syndrome is a condition where the patient is aware and awake but cannot move or communicate due to complete paralysis of nearly all voluntary muscles except for vertical eye movements and blinking.
D) Brain death is the irreversible cessation of all brain activity, including the brainstem, leading to the loss of all functions of the brain.