Nokea
The client with a pacemaker should be taught to:
- A. Report ankle edema
- B. Check his blood pressure daily
- C. Refrain from using a microwave oven
- D. Monitor his pulse rate
Correct Answer: D
Rationale: Monitoring pulse rate ensures the pacemaker is functioning correctly and detects arrhythmias.
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The home health care nurse is caring for a 30-year-old woman with type I diabetes mellitus. The client has been maintained on a regimen of NPH and regular insulin and a 1,800-calorie diabetic diet with normal blood sugar levels. Morning self-monitoring blood sugar (SMBG) readings the past two days were 205 mg/dL and 233 mg/dL. The nurse expects the physician to
- A. reduce the client’s diet to 1,500 calorie ADA.
- B. order 3 additional units of NPH insulin at 10 PM.
- C. order an additional 10 units of regular insulin at 8 PM.
- D. eliminate the client’s bedtime snack.
Correct Answer: B
Rationale: dawn phenomena, treatment is to adjust evening diet, bedtime snack, insulin dose, and exercise to prevent early morning hyperglycemia
During the change of shift, the oncoming nurse notes a discrepancy in the number of percocette listed and the number present in the narcotic drawer. The nurse's first action should be to:
- A. Notify the hospital pharmacist
- B. Notify the nursing supervisor
- C. Notify the Board of Nursing
- D. Notify the director of nursing
Correct Answer: B
Rationale: A narcotic discrepancy requires reporting to the supervisor for investigation.
A client has had 4 pregnancies. She experienced one miscarriage at 12 weeks, had one stillborn birth at 34 weeks, a healthy son at 38 weeks, and a healthy daughter at 40 weeks. How would the client's obstetric history be classified?
- A. Gravida 3, Para 2
- B. Gravida 4, Para 4
- C. Gravida 4, Para 3
- D. Gravida 4, Para 2
Correct Answer: D
Rationale: Gravida 4 (4 pregnancies), Para 2 (2 viable births at 38 and 40 weeks). Miscarriage and stillbirth count as pregnancies but not viable births.
Nurses must be familiar with the American Nurses Association (ANA) Code of Ethics for Nurses. The nurse understands that which ethical principle is defined as the nurse's duty to do no harm? Fill in the blank.
- A. Nonmaleficence
- B. Bneficence
- C. autonomy
Correct Answer: A
Rationale: Nonmaleficence is the ethical principle of doing no harm, a core duty in nursing practice.
A client with myasthenia gravis is admitted in a cholinergic crisis. Signs of of cholinergic crisis include:
- A. Decreased blood pressure and constricted pupils
- B. Increased heart rate and increased respirations
- C. Increased respirations and increased blood pressure
- D. Anoxia and absence of the cough reflex
Correct Answer: A
Rationale: Cholinergic crisis, due to excessive acetylcholinesterase inhibitors, causes symptoms like constricted pupils and decreased blood pressure from parasympathetic overstimulation.