Nokea
The nurse administered neutral protamine Hagedorn (NPH) insulin to a diabetic client at 7am. At what time would the nurse expect the client to be at most risk for a hypoglycemic reaction?
- A. 10:00 AM
- B. 4:00 PM
- C. Noon
- D. 10:00 PM
Correct Answer: B
Rationale: Rationale:
1. NPH insulin peaks in 4-12 hours, making 4:00 PM the highest risk time.
2. 10:00 AM is too soon for peak effect.
3. Noon is too early for peak effect.
4. 10:00 PM is too late for peak effect.
In summary, B is correct as it aligns with NPH insulin peak time, while other options are too early or too late.
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A client undergoes a biopsy of a suspicious lesion. The biopsy report classifies the lesion according to the TNM staging system as follows: TIS, NO, MO. What does this classification mean?
- A. No evidence of primary tumor, no abnormal regional lymph nodes, and no evidence of distant metastasis
- B. Carcinoma is situ, no abnormal regional lymph nodes, and no evidence of distant metastasis
- C. Can’t assess tumor or regional lymph nodes and no evidence of metastasis
- D. Carcinoma in situ, no demonstrable metastasis of the regional lymph nodes, and ascending degrees of distant metastasis
Correct Answer: B
Rationale: Step 1: TIS stands for carcinoma in situ, which means cancer cells are present only in the layer of cells where they first developed.
Step 2: N0 indicates no abnormal regional lymph nodes are involved.
Step 3: M0 signifies no evidence of distant metastasis.
Therefore, the correct answer is B because it accurately interprets the TNM staging system for the biopsy report.
Summary:
A: Incorrect - TIS indicates carcinoma in situ, not no evidence of primary tumor.
C: Incorrect - TIS already assesses tumor presence, ruling out this option.
D: Incorrect - TIS is not about ascending degrees of distant metastasis.
A client is admitted for postoperative assessment and recovery after surgery for a kidney tumor. The nurse needs to assess for signs of urinary tract infection. Which of the ff measures can be used to help detect UTI?
- A. Encourage the client to breathe deeply and cough every 2hrs
- B. Monitor temperature every 4hrs
- C. Splint the incision when repositioning the client
- D. Irrigate tubes as ordered CARING FOR CLIENTS WITH DISORDERS OF THE BLADDER AND URETHRA
Correct Answer: B
Rationale: The correct answer is B: Monitor temperature every 4hrs. This is crucial in detecting signs of urinary tract infection as fever is a common symptom. Monitoring temperature regularly allows for early detection and appropriate intervention.
A: Encouraging the client to breathe deeply and cough every 2hrs is a measure to prevent respiratory complications postoperatively, not related to UTI detection.
C: Splinting the incision when repositioning the client is important for wound care, not for detecting UTI.
D: Irrigating tubes as ordered is a specific intervention for tube care, not for monitoring UTI symptoms.
Which of the ff instructions should a nurse give a client with non-Hodgkin’s lymphoma who is being treated with radiation and chemotherapy?
- A. Increase fluid intake
- B. Intake low-fat meals
- C. Intake soft, bland foods
- D. Intake food rich in folic acid
Correct Answer: A
Rationale: The correct answer is A: Increase fluid intake. This is important for a client undergoing radiation and chemotherapy for non-Hodgkin's lymphoma to prevent dehydration, help flush out toxins, and support kidney function. Increasing fluid intake can also help manage side effects like nausea and vomiting. Choices B, C, and D are incorrect because low-fat meals, soft bland foods, and foods rich in folic acid are not specifically indicated for clients undergoing radiation and chemotherapy for non-Hodgkin's lymphoma.
A 48-year-old patient has been prescribed trihexyphenidyl for her Parkinson’s disease. Which adverse reaction to this drug can be close-related?
- A. Excessive salivation
- B. Bradycardia
- C. Dryness of mouth
- D. Constipation
Correct Answer: C
Rationale: Correct Answer: C - Dryness of mouth
Rationale:
1. Trihexyphenidyl is an anticholinergic medication commonly used to treat Parkinson's disease.
2. Anticholinergic drugs inhibit the parasympathetic nervous system, leading to decreased secretions.
3. Dryness of mouth (xerostomia) is a common side effect of anticholinergic medications.
4. Excessive salivation, bradycardia, and constipation are not typically associated with anticholinergic drugs, making them incorrect choices.
A client diagnosed with hyperosmolar hyperglycemic nonketotic syndrome (HHNS) is stabilized and prepared for discharge. When preparing the client for discharge and home management, which of the following statements indicates that the client understands her condition and how to control it?
- A. “I can avoid getting sick by not becoming dehydrated and by paying attention to my need to urinate, drink, or eat more than usual.”
- B. “If I experience trembling, weakness, and headache, I should drink a glass of soda that contains sugar.”
- C. “I will have to monitor my blood glucose level closely and notify the physician if it’s constantly elevated.”
- D. “If I begin to feel especially hungry and thirsty, I’ll eat a snack high in carbohydrates.”
Correct Answer: A
Rationale: The correct answer is A because it demonstrates an understanding of the key factors in managing hyperosmolar hyperglycemic nonketotic syndrome (HHNS), which include avoiding dehydration and being aware of changes in urination, thirst, and hunger. This statement shows awareness of the importance of maintaining hydration and recognizing early signs of worsening symptoms.
Choice B is incorrect as consuming sugary soda can exacerbate the condition by further increasing blood sugar levels. Choice C is incorrect because while monitoring blood glucose levels is important, it is not the primary method of preventing HHNS. Choice D is incorrect because consuming high-carbohydrate snacks can contribute to elevated blood glucose levels, which is counterproductive in managing HHNS.