Nokea
The client with Addison's disease is taking glucocorticoids. Which of the following statements indicates that the client understands how to take the medication?
- A. Various circumstances increase the need for glucocorticoids, so I will need to adjust the dosage.'
- B. My need for glucocorticoids will stabilize and I will be able to take a predetermined dose once a day.'
- C. Glucocorticoids are cumulative, so I will take a dose every third day.'
- D. I must take a dose every 6 hours to ensure consistent blood levels of glucocorticoids.'
Correct Answer: A
Rationale: Glucocorticoid needs vary with stress, requiring dose adjustments in Addison's disease to prevent adrenal crisis.
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Which pediatric surgery client should not play with a balloon?
- A. A child having her 15th laser surgery for a hemangioma.
- B. A child having a tonsillectomy.
- C. A child having an inguinal hernia repair.
- D. A child having an orchiopexy.
Correct Answer: B
Rationale: A child post-tonsillectomy should avoid balloons, as blowing or playing with them can increase intraoral pressure, risking bleeding or disruption of the surgical site.
A client wakes up in the postanesthesia care unit and sees a drain with bright red fluid in it exiting from her total hip incision. She asks the nurse, 'Is this supposed to be there?' Which of the following represents the nurse's best response?
- A. œThe drainage is blood and fluid that must be drained out for healing.'
- B. œDon't worry about it. I will explain it when you are more awake.'
- C. œThis blood is being kept sterile and will be given back to you.'
- D. œI will give you something to make you sleep so you will not worry.'
Correct Answer: A
Rationale: Explaining that the drain removes blood and fluid for healing reassures the client and accurately describes the purpose of the drain in a total hip incision.
The most appropriate suggestion for the hospice nurse to give a woman whose husband died 3 months ago and her three young children would be to:
- A. Seek group counseling support for the three children.
- B. Request individual counseling and medication to manage depression.
- C. Remind her gently that bereavement care before the child's effective grieving.
- D. Continue her bereavement support through hospice.
Correct Answer: D
Rationale: Continuing bereavement support through hospice provides ongoing emotional support for the woman and her children, tailored to their needs during grief.
A client with macrocytic anemia has a burn on her foot and states that she had been watching television while lying on a heating pad. Which action should be the nurse's first response?
- A. Assess for potential abuse.
- B. Check for diminished sensations.
- C. Document the findings.
- D. Clean and dress the area.
Correct Answer: B
Rationale: Macrocytic anemia, often due to vitamin B12 or folate deficiency, can cause peripheral neuropathy, leading to diminished sensations and increased risk of burns from prolonged heat exposure. The nurse's first action should be to check for sensory deficits to assess the underlying cause of the injury. Assessing for abuse, documenting, or dressing the wound are secondary actions.
A young adult client has been diagnosed with type 1 diabetes. He has an insulin drip to aid in lowering the serum blood glucose level of 600 mg/dL. He is also receiving I.V. antibiotics for a urinary tract infection. After 4 hours, the physician orders discontinuation of the insulin drip. The nurse should next?
- A. Discontinue the insulin drip, as ordered.
- B. Hang the next I.V. dose of antibiotic before discontinuing the insulin drip.
- C. Inform the physician that the client has not received any subcutaneous insulin yet.
- D. Add glargine (Lantus) to the insulin drip before discontinuing it.
Correct Answer: C
Rationale: Discontinuing an insulin drip without initiating subcutaneous insulin risks rebound hyperglycemia in type 1 diabetes. The nurse should inform the physician to ensure a subcutaneous insulin order is in place.