Nokea
The clinic nurse is reinforcing teaching to a client who has been prescribed transdermal scopolamine to prevent motion sickness during an upcoming vacation on a cruise ship. Which of the following statements made by the nurse are appropriate? Select all that apply.
- A. Apply the patch when the ship starts moving and not before.'
- B. Dispose of the patch out of reach of children and pets.'
- C. Ensure that the old patch is removed before applying a new one.'
- D. Place the patch on a hairless, clean, dry area behind the ear.'
- E. Wash your hands with soap and water after handling the patch.'
Correct Answer: B,C,D,E
Rationale: Appropriate scopolamine instructions include safe disposal , removing old patches , correct placement , and hand washing . Applying the patch only when moving is incorrect, as it should be applied hours before travel.
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The client tells the nurse she is having trouble falling asleep. What initial nursing action is least appropriate?
- A. Asking the physician for a sleeping medication
- B. Offering the client a back rub
- C. Asking the client if she is concerned about something
- D. Repositioning the client
Correct Answer: A
Rationale: Requesting sleeping medication is premature and least appropriate without exploring non-pharmacologic interventions like back rubs, addressing concerns, or repositioning, which promote sleep naturally.
In the intensive care unit, the nurse cares for a client admitted with a head injury who develops syndrome of inappropriate antidiuretic hormone. Which data should the nurse expect with the onset of this condition? Select all that apply.
- A. Decreased serum osmolality
- B. High serum osmolality
- C. High urine specific gravity
- D. Increased urine output
- E. Low serum sodium
Correct Answer: A,C,E
Rationale: SIADH causes water retention, leading to decreased serum osmolality , high urine specific gravity , and low serum sodium due to dilution. High osmolality and increased urine output are opposite findings.
The nurse is planning a client care conference with the parents of a 3-year-old with newly diagnosed type 1 diabetes mellitus. What is the priority outcome for the caregivers?
- A. Demonstrating adequate coping skills
- B. Knowing how to keep blood sugars stable
- C. Understanding how to perform meal planning
- D. Understanding the need for periodic follow-up visits
Correct Answer: B
Rationale: The priority outcome for caregivers of a child with type 1 diabetes is knowing how to keep blood sugars stable , as this directly impacts the child's health and prevents complications. Coping , meal planning , and follow-up are important but secondary.
A client with metabolic acidosis associated with diabetes mellitus is admitted to the unit. A blood glucose of $250 \mathrm{mg} / \mathrm{dl}$ is present. Which symptom will most likely accompany ketoacidosis?
- A. Oliguria
- B. Polydipsia
- C. Perspiration
- D. Tremors
Correct Answer: B
Rationale: Diabetic ketoacidosis (DKA) causes dehydration due to hyperglycemia, leading to polydipsia (excessive thirst). Oliguria may occur later, perspiration is not specific, and tremors are more associated with hypoglycemia.
After passing a nasogastric (NG) tube in an adult, the nurse checks for proper placement by doing which of the following?
- A. Injecting air into the NG tube and listening with a stethoscope over the stomach for a 'swoosh'
- B. Putting the end of the NG tube in a glass of water and observing for bubbles
- C. Asking the client if the tube is comfortable
- D. Aspirating contents and checking the pH
Correct Answer: D
Rationale: Aspirating gastric contents and checking pH (typically 1-5 for stomach) is the most reliable method to confirm NG tube placement in the stomach. Air injection is less definitive, water bubbling is unsafe, and comfort does not confirm placement.