The community health nurse has been following the care for an adolescent with a history of morbid obesity, asthma, hypertension, and is 22 weeks into a pregnancy. Which of these lab reports sent to the clinic needs to be called to the teen's healthcare provider within the next hour?
- A. Hemoglobin 11 g/dL and calcium 6 mg/dL
- B. Magnesium 0.8 mEq/L and creatinine 3 mg/dL
- C. Blood urea nitrogen 28 mg/dL and glucose 225 mg/dL
- D. Hematocrit 33% and platelets 200,000
Correct Answer: B
Rationale: The correct answer is B. The low magnesium level and elevated creatinine suggest possible renal dysfunction, which is concerning, especially in a pregnant client with multiple risk factors such as morbid obesity, asthma, and hypertension. Immediate attention is needed to address the potential renal issues. The other choices do not indicate such urgent conditions. Hemoglobin and calcium levels in choice A are within acceptable ranges. Choice C shows elevated blood urea nitrogen and glucose levels, which may need monitoring but not immediate attention. Choice D's hematocrit and platelet levels are also within normal ranges and do not indicate an urgent issue.
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The client with atrial fibrillation is being taught about the use of Coumadin (warfarin) at home. Which of these should be emphasized to the client to avoid?
- A. Large indoor gatherings
- B. Exposure to sunlight
- C. Active physical exercise
- D. Foods rich in vitamin K
Correct Answer: D
Rationale: The correct answer is D: Foods rich in vitamin K. Foods rich in vitamin K can interfere with the effectiveness of Coumadin (warfarin) by promoting blood clotting. It is crucial for clients on this medication to maintain a consistent intake of vitamin K and avoid sudden dietary changes. Choices A, B, and C are incorrect as they are not directly related to the interaction of Coumadin (warfarin) with vitamin K. Large indoor gatherings, exposure to sunlight, and active physical exercise do not have a significant impact on the effectiveness of Coumadin (warfarin) in comparison to the interaction with foods rich in vitamin K.
A client with acute pancreatitis is receiving total parenteral nutrition (TPN). The nurse should monitor the client for which of the following complications?
- A. Hypoglycemia
- B. Hyperkalemia
- C. Hyperglycemia
- D. Hyponatremia
Correct Answer: C
Rationale: The correct answer is C: Hyperglycemia. Total parenteral nutrition (TPN) contains a high glucose content, which can lead to elevated blood sugar levels, resulting in hyperglycemia. Monitoring for hyperglycemia is crucial in clients receiving TPN to prevent complications such as osmotic diuresis, dehydration, and electrolyte imbalances. Choices A, B, and D are incorrect because TPN is more likely to cause hyperglycemia rather than hypoglycemia, hyperkalemia, or hyponatremia.
A community health nurse is conducting a neighborhood discussion group about disaster planning. What information regarding the transmission of anthrax should the nurse provide to the group?
- A. Infection is acquired when anthrax spores enter a host.
- B. Mature anthrax bacteria live dormant on inanimate objects.
- C. Spores cannot survive for extended periods outside of a living host.
- D. Anthrax is transmitted by respiratory droplets from person to person.
Correct Answer: A
Rationale: The correct information that the nurse should provide to the group is that anthrax infection occurs when spores enter a host. Choice B is incorrect because mature anthrax bacteria do not live dormant on inanimate objects. Choice C is incorrect because anthrax spores can survive for extended periods outside of a living host. Choice D is incorrect because anthrax is not transmitted by respiratory droplets from person to person; it is acquired through spores entering a host.
Which of the following best describes the concept of 'health disparity'?
- A. Differences in health outcomes and their determinants between different segments of the population
- B. Providing equal healthcare services to all individuals
- C. Access to healthcare services regardless of income
- D. High-quality healthcare for everyone
Correct Answer: A
Rationale: The correct answer is A: 'Differences in health outcomes and their determinants between different segments of the population.' Health disparity refers to variations in health status or health care utilization between different groups. Choice B is incorrect because providing equal healthcare services to all individuals is related to health equity, not health disparity. Choice C is also incorrect as it refers to universal access to healthcare, which is different from health disparity. Choice D is incorrect as it describes the concept of high-quality healthcare for everyone, not health disparity.
A client with terminal cancer is experiencing severe pain. The nurse plans to implement which of the following pain management strategies?
- A. Administer analgesics on a fixed schedule
- B. Administer analgesics only when the client requests
- C. Use non-pharmacological methods only
- D. Increase the dose of analgesics when the client complains of pain
Correct Answer: A
Rationale: Administering analgesics on a fixed schedule is the most appropriate pain management strategy for a client with terminal cancer experiencing severe pain. This approach ensures consistent pain control and helps prevent breakthrough pain. Administering analgesics only when the client requests (Choice B) may lead to uncontrolled pain as the client may delay requesting medication until the pain becomes unbearable. Using non-pharmacological methods only (Choice C) may not provide adequate pain relief for a client experiencing severe pain. Increasing the dose of analgesics when the client complains of pain (Choice D) may result in inconsistent pain control and could lead to potential overdose or adverse effects.