Nokea
The male client diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH) secondary to cancer of the lung tells the nurse he wants to discontinue the fluid restriction and does not care if he dies. Which action by the nurse is an example of the ethical principle of autonomy?
- A. Discuss the information the client told the nurse with the health-care provider and significant other.
- B. Explain it is possible the client could have a seizure if he drank fluid beyond the restrictions.
- C. Notify the health-care provider of the client's wishes and give the client fluids as desired.
- D. Allow the client an extra drink of water and explain the nurse could get into trouble if the client tells the health-care provider.
Correct Answer: C
Rationale: Notifying the HCP and respecting the client’s fluid request honors autonomy. Sharing with others violates confidentiality, explaining risks is beneficence, and covertly giving water is unethical.
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The nurse is discussing discharge plans with a client who had a transsphenoidal hypophysectomy. Which statement made by the client indicates a need for more teaching?
- A. I won't brush my teeth until the doctor removes the stitches.'
- B. I will wear loafers instead of tie shoes.'
- C. Where can I get a Medic-Alert bracelet?'
- D. I will take all these new medicines until I feel better.'
Correct Answer: D
Rationale: Stopping medications when feeling better indicates a lack of understanding, as lifelong hormone replacement is often required post-hypophysectomy.
What must the nurse do when preparing a client for a computed tomography (CT) scan?
- A. Administer a laxative prep
- B. Encourage fluids
- C. Explain the procedure
- D. Administer a radioisotope
Correct Answer: C
Rationale: Explaining the procedure reduces anxiety and ensures cooperation. A CT scan may involve iodine dye, so checking for allergies (e.g., shellfish) is also important, but explanation is primary.
When the client practices self-administration of the insulin, which action is correct?
- A. Piercing the skin at a 30-degree angle
- B. Using a syringe calibrated in minims
- C. Using a 29-gauge needle on the syringe
- D. Rotating abdominal sites for each injection
Correct Answer: D
Rationale: Rotating abdominal sites prevents lipodystrophy and ensures consistent insulin absorption.
After the client returns from surgery and resumes eating, the nurse should encourage the client to eat foods from which food group?
- A. Bread and cereals
- B. Milk and cheese
- C. Meat and seafood
- D. Fruit and vegetables
Correct Answer: B
Rationale: Milk and cheese are rich in calcium, essential for clients post-parathyroidectomy to prevent hypocalcemia.
The client diagnosed with type 1 diabetes has a glycosylated hemoglobin (A1c) of 8.1%. Which interpretation should the nurse make based on this result?
- A. This result is below normal levels.
- B. This result is within acceptable levels.
- C. This result is above recommended levels.
- D. This result is dangerously high.
Correct Answer: C
Rationale: An A1c of 8.1% is above the recommended target (<7% for most diabetics), indicating poor glycemic control. It is not normal, acceptable, or dangerously high (e.g., >10%).