Nokea
The client is taking prednisone 7.5 mg po each morning to treat his systemic lupus erythematosis. Which statement best explains the reason for taking the prednisone in the morning?
- A. There is less chance of forgetting the medication if taken in the morning.
- B. There will be less fluid retention if taken in the morning.
- C. Prednisone is absorbed best with the breakfast meal.
- D. Morning administration mimics the body's natural secretion of corticosteroid.
Correct Answer: D
Rationale: Morning dosing aligns with the body's natural cortisol peak, minimizing adrenal suppression.
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The nurse is preparing to administer a dose of regular insulin to a client based on a sliding scale. The client’s blood glucose is 320 mg/dL. The sliding scale orders 6 units of regular insulin for a blood glucose of 301–350 mg/dL. Which of the following actions should the nurse take?
- A. Administer 6 units of regular insulin.
- B. Administer 8 units of regular insulin.
- C. Withhold the insulin and notify the physician.
- D. Recheck the blood glucose in 30 minutes.
Correct Answer: A
Rationale: the sliding scale indicates 6 units for a blood glucose of 320 mg/dL, so the dose is correct
A client with an esophageal tamponade develops symptoms of respiratory distress, including inspiratory stridor. The nurse should give priority to:
- A. Applying oxygen at 4 L via nasal cannula
- B. Removing the tube after deflating the balloons
- C. Elevating the head of the bed to 45°
- D. Increasing the pressure in the esophageal balloon
Correct Answer: B
Rationale: Respiratory distress with stridor suggests airway obstruction from the tamponade, requiring immediate tube removal after deflation to restore airway patency.
A primigravida with(choices truncated due to document error; assuming standard options for context) diabetes is admitted to the labor and delivery unit at 34 weeks gestation. Which doctor's order should the nurse question?
- A. Magnesium sulfate 4 gm (25%) IV
- B. Brethine 10 mcg IV
- C. Stadol 1 mg IV push every 4 hours as needed prn for pain
- D. Ancef 2 gm IVPB every 6 hours
Correct Answer: B
Rationale: Brethine (terbutaline) is a tocolytic that can exacerbate maternal diabetes by causing hyperglycemia, so this order should be questioned in a diabetic primigravida.
Which obstetrical client is most likely to have an infant with respiratory distress syndrome?
- A. A 28-year-old with a history of alcohol use during the pregnancy
- B. A 24-year-old with a history of diabetes mellitus
- C. A 30-year-old with a history of smoking during the pregnancy
- D. A 32-year-old with a history of pregnancy-induced hypertension
Correct Answer: B
Rationale: Maternal diabetes increases the risk of respiratory distress syndrome in infants due to impaired surfactant production from fetal hyperglycemia.
A nurse asks an unlicensed assistive personnel (UAP) to help admit a 22-year-old female client with ulcerative colitis. Which activity is appropriate for the nurse to assign the UAP?
- A. obtain a stool sample
- B. obtain abbreviated history of symptoms for the past 30 days
- C. instruct the client on the reason for undergoing a lower gastric X-ray exam
- D. obtain a sample of gastric contents from nasogastric tube
Correct Answer: A
Rationale: Obtaining a stool sample is within the UAP’s scope, as it is a non-invasive task. Other activities involve assessment or teaching, which require RN expertise.