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The clinic nurse is reviewing strategies for blood glucose monitoring with a client who is newly diagnosed with diabetes mellitus. When helping the client select a blood glucose meter, which client assessments should the nurse complete?
- A. Manual dexterity and visual acuity
- B. Capillary refill time and radial pulse volume
- C. Deep tendon reflexes and skin color
- D. Skin elasticity and hand grip strength
Correct Answer: A
Rationale: Manual dexterity and visual acuity are important for the client to properly use the glucose meter.
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A female client enters the clinic and insists on being seen. She is weak, nervous, and reports a racing heart beat and recent weight loss of 15 pounds. After ruling out substance withdrawal, the healthcare provider suspects hyperthyroidism and admits her for further testing. Which action should the nurse implement?
- A. Begin preparing client for thyroidectomy procedure
- B. Space the client's care to provide periods of rest
- C. Assess the client for hyperactive bowel sounds
- D. Provide warm blankets to prevent heat loss
Correct Answer: B
Rationale: Rest is important for managing symptoms of hyperthyroidism, which can be exacerbated by stress and activity.
A nurse assesses an older adult client who has multiple chronic diseases. The client’s heart rate is 48 beats/min. Which action should the nurse take first?
- A. Document the finding in the chart.
- B. Initiate external pacing.
- C. Assess the client’s medications.
- D. Administer 1 mg of atropine.
Correct Answer: C
Rationale: A heart rate of 48 beats/min (bradycardia) in an older adult with multiple chronic diseases may be due to medication side effects. Assessing the client’s medications is the first step to determine if any drugs are contributing to the bradycardia.
Aspirin has been ordered for the child with rheumatic fever (RF) in order to:
- A. Keep the patent ductus arteriosus (PDA) open
- B. Reduce joint inflammation
- C. Decrease swelling of strawberry tongue
- D. Treat ventricular hypertrophy of endocarditis
Correct Answer: B
Rationale: Aspirin helps alleviate the joint inflammation and pain experienced in RF.
Regarding ECG in infancy
- A. T Wave inversion present
- B. PR interval is < 0.16 s
- C. P wave is < 3mm tall
- D. QRS represent ventricular depolarization
Correct Answer: B
Rationale: In infants, the PR interval is shorter than in adults (< 0.16 seconds).
The typical radiologic configuration in tetralogy of Fallot as seen in the anteroposterior view consists of all the following EXCEPT
- A. normal heart size
- B. some elevation of the cardiac apex
- C. convexity in the region of the main pulmonary artery
- D. right-sided aortic arch
Correct Answer: A
Rationale: Normal heart size is not typical in tetralogy of Fallot.