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The emergency department nurse is caring for a 70-year-old client with a history of type 2 diabetes mellitus who reports sudden-onset nausea, sweating, dizziness, and fatigue. The nurse should anticipate the initiation of which protocol?
- A. Food poisoning
- B. Influenza
- C. Myocardial infarction
- D. Stroke
Correct Answer: C
Rationale: Symptoms like nausea, sweating, dizziness, and fatigue in a 70-year-old with diabetes suggest myocardial infarction, requiring immediate cardiac protocol initiation.
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The nurse is teaching an elderly client how to use MDIs (multi-dose inhalers). The nurse is concerned that the client is unable to coordinate the release of the medication with the inhalation phase. What is the nurse's best recommendation to improve delivery of the medication?
- A. Nebulized treatments for home care
- B. Adding a spacer device to the MDI canister
- C. Asking a family member to assist the client with the MDI
- D. Request a visiting nurse to follow the client at home
Correct Answer: B
Rationale: If the client is not using the MDI properly, the medication can get trapped in the upper airway, resulting in dry mouth and throat irritation. Using a spacer will allow more drug to be deposited in the lungs and less in the mouth.
The parent of an 8-year-old client asks the nurse for guidance on how to help the client cope with the recent death of the other parent. When developing a response to the parent, the nurse considers that a school-aged child is most likely to do what?
- A. React anxiously to altered daily routines
- B. Realize that death eventually affects everyone
- C. Think about the religious or spiritual aspects of death
- D. Understand that death is permanent but be curious about it
Correct Answer: D
Rationale: School-aged children (around 8 years old) typically understand death's permanence and may exhibit curiosity about it, which can guide coping strategies. A is more common in younger children. B and C are more typical of adolescents, who have more abstract thinking.
The nurse is reinforcing education to a group of parents about ways to decrease the risk of sudden infant death syndrome. Which of the following recommendations should the nurse suggest? Select all that apply.
- A. Breastfeeding the infant
- B. Cosleeping with the infant in the parent's bed
- C. Giving the infant a pacifier at bedtime
- D. Maintaining a smoke-free environment
- E. Placing the infant to sleep in a side-lying position
Correct Answer: A,C,D
Rationale: Breastfeeding, pacifier use, and a smoke-free environment reduce SIDS risk. Cosleeping and side-lying positions increase risk.
A newly admitted client describes symptoms of dizziness and feeling faint on standing. The client has a history of type 2 diabetes, coronary artery disease, and bipolar disorder. Which medications may be contributing to the client's symptoms? Select all that apply.
- A. Atorvastatin
- B. Metformin
- C. Metoprolol
- D. Olanzapine
- E. Omeprazole
Correct Answer: C,D
Rationale: Metoprolol, a beta-blocker, can cause orthostatic hypotension, leading to dizziness on standing. Olanzapine, an antipsychotic, is associated with orthostatic hypotension as a side effect. A, B, and E are not commonly linked to orthostatic symptoms; atorvastatin manages cholesterol, metformin controls blood sugar, and omeprazole reduces stomach acid.
The nurse is caring for clients who are having the following procedures. Which client should be asked about allergies to shellfish?
- A. The client who is having an arthroscopy
- B. The client who is having an arthrocentesis
- C. The client who is having a myelogram
- D. The client who is having an electromyogram (EMG)
Correct Answer: C
Rationale: Myelograms often use iodine-based contrast; shellfish allergies may indicate iodine sensitivity, requiring verification. Arthroscopy, arthrocentesis, and EMG do not typically involve contrast.