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The home health nurse is admitting a client diagnosed with cancer of the pancreas. Which information is the most important for the nurse to discuss with the client?
- A. Determine the client's food preferences.
- B. Ask the client if there is an advance directive.
- C. Find out about insurance/Medicare reimbursement.
- D. Explain the client should eat as much as possible.
Correct Answer: B
Rationale: An advance directive is critical for pancreatic cancer due to poor prognosis, ensuring the client’s wishes are respected. Food preferences, insurance, and eating are secondary.
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The client with DM is to receive insulin IV at 1.5 units per hour. The insulin bag contains 10 units of insulin in 100 mL of NS. The nurse should set the infusion pump to deliver how many milliliters per hour?
- A. 1.0 mL/hr
- B. 1.5 mL/hr
- C. 2.0 mL/hr
- D. 2.5 mL/hr
Correct Answer: B
Rationale: 10 units : 100 mL :: 1.5 units : X mL; 10X = 150; X = 1.5 mL/hr.
The client diagnosed with Addison's disease is admitted to the emergency department after a day at the lake. The client is lethargic, forgetful, and weak. Which intervention should the nurse implement?
- A. Start an IV with an 18-gauge needle and infuse NS rapidly.
- B. Have the client wait in the waiting room until a bed is available.
- C. Obtain a permit for the client to receive a blood transfusion.
- D. Collect urinalysis and blood samples for a CBC and calcium level.
Correct Answer: A
Rationale: Lethargy, confusion, and weakness suggest Addisonian crisis; rapid NS infusion corrects hypotension and dehydration. Waiting, transfusions, and labs are inappropriate first steps.
Which signs/symptoms should the nurse expect to assess in the 31-year-old client who has a sustained release of growth hormone (GH)?
- A. An enlarged forehead, maxilla, and face.
- B. A six (6)-inch increase in height of the client.
- C. The client complaining of a severe headache.
- D. A systolic blood pressure of 200 to 300 mm Hg.
Correct Answer: A
Rationale: Excess GH (acromegaly) causes facial and bone enlargement (e.g., forehead, maxilla). Height increase occurs pre-puberty, headaches are nonspecific, and extreme hypertension is unrelated.
The nurse is interviewing four clients. Which client is at the greatest risk for developing type 2 DM?
- A. 56-year-old Hispanic female
- B. 40-year-old Asian American female
- C. 25-year-old obese Caucasian male
- D. 38-year-old Native American male
Correct Answer: D
Rationale: Research has shown that the highest incidence of DM is among Native Americans.
Before administering this medication, what is essential for the nurse to ask the client?
- A. Do you have trouble swallowing?
- B. Do you keep the child form of medication?
- C. Have you had digestive disorders in the past?
- D. Is there a possibility you could be pregnant?
Correct Answer: D
Rationale: Propylthiouracil is contraindicated in pregnancy due to potential teratogenic effects.