Nokea
The client admitted with peripheral vascular disease (PVD) asks the nurse why her legs hurt when she walks. The nurse bases a response on the knowledge that the main characteristic of PVD is:
- A. Decreased blood flow.
- B. Increased blood flow.
- C. Slow blood flow.
- D. Thrombus formation.
Correct Answer: A
Rationale: The correct answer is A: 'Decreased blood flow.' In peripheral vascular disease (PVD), there is a narrowing or blockage of blood vessels, leading to reduced blood flow to the extremities. This decreased blood flow results in inadequate oxygen supply to the muscles, causing pain, especially during physical activity when oxygen demand increases. Choice B, 'Increased blood flow,' is incorrect because PVD is characterized by impaired blood circulation rather than increased flow. Choice C, 'Slow blood flow,' is not precise as PVD involves a more significant reduction in blood flow. Choice D, 'Thrombus formation,' is related to the formation of blood clots within vessels, which can be a complication of PVD but is not its main characteristic.
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An older client with long-term type 2 diabetes Mellitus (DM) is seen in the clinic for a routine health assessment. Which assessment would the nurse complete to determine if a patient with type 2 diabetes Mellitus (DM) is experiencing long-term complications?
- A. Signs of respiratory tract infection
- B. Sensation in feet and legs
- C. Skin condition of lower extremities
- D. Serum creatinine and blood urea nitrogen (BUN)
Correct Answer: B
Rationale: Assessing sensation in the feet and legs is crucial for detecting diabetic neuropathy, a common long-term complication of diabetes. While signs of respiratory tract infection, skin condition of lower extremities, and serum creatinine and blood urea nitrogen levels are important assessments in diabetic care, they are not specific for detecting long-term complications like neuropathy.
A middle-aged adult with a family history of CAD has the following: total cholesterol 198 (11 mmol/L); LDL cholesterol 120 (6.7 mmol/L); HDL cholesterol 58 (3.2 mmol/L); triglycerides 148 (8.2 mmol/L); blood sugar 102 (5.7 mmol/L); and C-reactive protein (CRP) 4.2. The health care provider prescribes a statin medication and aspirin. The client asks the nurse why these medications are needed. Which is the best response by the nurse?
- A. The labs indicate severe hyperlipidemia and the medications will lower your LDL, along with a low-fat diet.
- B. The triglycerides are elevated and will not return to normal without these medications.
- C. The CRP is elevated indicating inflammation seen in cardiovascular disease, which can be lowered by the medications prescribed.
- D. These medications will reduce the risk of type 2 diabetes.
Correct Answer: C
Rationale: CRP is a marker of inflammation, which is elevated in cardiovascular disease. Statins and aspirin help lower CRP and reduce the risk of heart attacks and strokes.
Which of the following lab results is most indicative of dehydration?
- A. Low sodium levels.
- B. Elevated creatinine levels.
- C. Low potassium levels.
- D. High blood glucose levels.
Correct Answer: B
Rationale: Elevated creatinine levels are indicative of dehydration because when the body is dehydrated, the kidneys concentrate urine to preserve fluid, leading to higher levels of creatinine. Low sodium levels (Choice A) can be seen in conditions like hyponatremia but are not specific to dehydration. Low potassium levels (Choice C) are more commonly associated with conditions like hypokalemia. High blood glucose levels (Choice D) are typically seen in diabetes and are not specific indicators of dehydration.
A client with diabetes begins to cry and says, 'I just cannot stand the thought of having to give myself a shot every day.' Which of the following would be the best response by the nurse?
- A. If you do not give yourself your insulin shots, you will die.
- B. We can teach your daughter to give the shots so you will not have to do it.
- C. I can arrange to have a home care nurse give you the shots every day.
- D. What is it about giving yourself the insulin shots that bothers you?
Correct Answer: D
Rationale: The correct response is option D because it is an open-ended question that allows the client to express their feelings and concerns. This approach facilitates a therapeutic communication process by encouraging the client to verbalize their thoughts, emotions, and fears related to giving themselves insulin shots. Option A is incorrect as it uses a fear-inducing statement that may not be helpful in addressing the client's emotional needs. Option B assumes involvement of a family member without exploring the client's feelings further. Option C offers a solution without addressing the client's underlying concerns and emotions, potentially overlooking essential aspects of client-centered care.
What is a key intervention for a patient with diabetic ketoacidosis (DKA)?
- A. Administering insulin
- B. Administering IV fluids
- C. Administering oral glucose
- D. Administering oral fluids
Correct Answer: A
Rationale: Administering insulin is a crucial intervention for a patient with diabetic ketoacidosis (DKA) because it helps in managing hyperglycemia and ketosis by promoting the uptake of glucose by cells and inhibiting the production of ketones. IV fluids are necessary to correct dehydration and electrolyte imbalances commonly seen in DKA but are not the primary treatment for the condition. Administering oral glucose would exacerbate hyperglycemia in a patient with DKA, while administering oral fluids alone would not effectively address the underlying metabolic disturbances seen in DKA.