Nokea
The client with Addison's disease should anticipate the need for increased glucocorticoid supplementation in which of the following situations:
- A. Returning to work after a weekend.
- B. Going on vacation.
- C. Having oral surgery.
- D. Having a routine medical checkup.
Correct Answer: C
Rationale: Oral surgery is a stressful event requiring increased glucocorticoid supplementation to prevent adrenal crisis.
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The nurse in the emergency department (ED) is caring for a 62-year-old male client.
Item 3 of 6
Triage Note
1700:
• The client was brought to the ED after collapsing on a tennis court.
• Vital signs: BP 94/57, T 105° F (40.5° C), P 115, RR 26, Pulse oximetry 95% on room air. • The client is lethargic and confused. Skin is pale, and there is some perspiration on the forehead. Thready peripheral pulses, clear lung fields bilaterally, tachypnea, shallow respirations.
The client is at highest risk for developing ……………..
- A. stroke.
- B. multiple organ dysfunction.
- C. a myocardial infarction.
- D. respiratory acidosis.
Correct Answer: B
Rationale: The client's severe hyperthermia, hypotension, tachycardia, and confusion suggest heat stroke, which can lead to multiple organ dysfunction due to systemic inflammation and hypoperfusion. Stroke (A), myocardial infarction (C), and respiratory acidosis (D) are less directly associated with heat stroke complications.
When using a Doppler instrument to assess peripheral pulses, the correct placement of the transducer is important because it is difficult to differentiate between:
- A. Arterial and capillary blood flow
- B. Arterial and venous blood flow
- C. Arterial and arteriole blood flow
- D. Capillary and venous blood flow
Correct Answer: B
Rationale: Doppler ultrasound can detect both arterial (pulsatile) and venous (continuous) blood flow, but incorrect transducer placement may confuse these signals. Differentiating arterial from venous flow is critical in PVD assessment to confirm arterial patency. Capillary or arteriole flow is less relevant in this context.
A client has been admitted with acute renal failure. What should the nurse do? Select all that apply.
- A. Elevate the head of the bed 30 to 45 degrees.
- B. Take vital signs.
- C. Establish an I.V. access site.
- D. Call the admitting physician for orders.
- E. Contact the hemodialysis unit.
Correct Answer: B,C,D
Rationale: Taking vital signs, establishing IV access, and contacting the physician are immediate actions to assess and stabilize the client with acute renal failure.
What is a key nursing intervention for a client receiving peritoneal dialysis?
- A. Monitor for signs of peritonitis.
- B. Restrict protein intake.
- C. Administer anticoagulants.
- D. Limit ambulation.
Correct Answer: A
Rationale: Peritonitis is a serious complication of peritoneal dialysis, requiring vigilant monitoring.
Following a laryngectomy, the nurse notices that the client has saliva collecting beneath the skin flaps. This finding is indicative of which of the following?
- A. Skin necrosis.
- B. Carotid artery rupture.
- C. Stomal Stenosis.
- D. Development of a fistula.
Correct Answer: D
Rationale: Saliva collecting beneath skin flaps post-laryngectomy indicates a fistula, where saliva leaks from the pharynx or esophagus into surrounding tissues, requiring immediate attention.