Nokea
The client is admitted with a diagnosis of hypovolemic shock. Which fluid is most appropriate for initial resuscitation?
- A. 0.9% Normal saline
- B. 5% Dextrose in water
- C. 3% Sodium chloride
- D. Lactated Ringer’s
Correct Answer: A
Rationale: 0.9% Normal saline is the preferred isotonic fluid for initial resuscitation in hypovolemic shock to restore intravascular volume. Dextrose is hypotonic, 3% saline is hypertonic, and lactated Ringer’s is used in specific cases like burns.
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The nurse is caring for a client hospitalized with bipolar disorder, manic phase. Which of the following snacks would be best for the client?
- A. Potato chips
- B. Diet cola
- C. Apple
- D. Milkshake
Correct Answer: C
Rationale: An apple is a healthy, easy-to-eat snack that provides nutrition without excessive sodium (chips), caffeine (cola), or high calories (milkshake), suitable for a manic client needing stability.
An adolescent client with cystic acne has a prescription for Accutane (isotretinoin). Which lab work is needed before beginning the medication?
- A. Complete blood count
- B. Clean-catch urinalysis
- C. Liver profile
- D. Thyroid function test
Correct Answer: C
Rationale: Isotretinoin can cause liver toxicity, requiring a baseline liver profile to monitor for elevations in liver enzymes. CBC, urinalysis, and thyroid tests are not primary concerns.
The client is admitted with a diagnosis of acute renal failure. Which laboratory value is most expected?
- A. Elevated creatinine
- B. Decreased potassium
- C. Elevated hemoglobin
- D. Decreased blood urea nitrogen
Correct Answer: A
Rationale: Elevated creatinine is a hallmark of acute renal failure, reflecting impaired kidney filtration. Hyperkalemia, decreased hemoglobin, and elevated BUN are more common than low potassium or BUN.
The nurse is assessing a trauma client in the emergency room when she notes a penetrating abdominal wound with exposed viscera. The nurse should:
- A. Apply a clean dressing to protect the wound.
- B. Cover the exposed viscera with a sterile saline gauze.
- C. Gently replace the abdominal contents.
- D. Cover the area with a petroleum gauze.
Correct Answer: B
Rationale: Exposed viscera should be covered with sterile saline-soaked gauze to keep them moist and prevent infection until surgical repair. Replacing contents or using non-sterile/petroleum dressings is unsafe.
A type I diabetic client is diagnosed with cellulitis in his right lower extremity. The nurse would expect which of the following to be present in relation to his blood sugar level?
- A. A normal blood sugar level
- B. A decreased blood sugar level
- C. An increased blood sugar level
- D. Fluctuating levels with a predawn increase
Correct Answer: C
Rationale: Hyperglycemia occurs due to glucose production in response to the stress and illness of cellulitis.