Nokea
The nurse caring for an adult client. The nurse will need to monitor for which of the following metabolic complications?
- A. hypoglycemia and hypercalcemia
- B. hyperglycemia and hyperkalemia
- C. hyperglycemia and Hypokalemia
- D. hyperkalemia and hypercalcemia
Correct Answer: C
Rationale: Monitoring for hyperglycemia and hypokalemia is crucial when caring for an adult client, especially if the client has a history of diabetes or other conditions that can affect glucose and potassium levels.
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Nurse Raymond is handling a group of student nurses and he is teaching them about fluids and electrolytes. He is correct when he says that a substance moves from an area of higher concentration, this is:
- A. osmosis
- B. filtration
- C. diffusion
- D. active transport
Correct Answer: C
Rationale: Diffusion is the movement of molecules from an area of higher concentration to an area of lower concentration. In the context of fluids and electrolytes, this process plays a crucial role in maintaining the balance of these substances in the body. Nurse Raymond is correct in stating that diffusion is the mechanism by which substances move down their concentration gradient. Osmosis involves the movement of water across a semipermeable membrane, filtration is the process of separating substances based on size through a filtering mechanism, and active transport requires energy to move substances against their concentration gradient.
A client is admitted to an acute care facility with a tentative diagnosis of hypoparathyroidism. The nurse should monitor the client closely for the related problem of:
- A. Severe hypotension
- B. Profound neuromuscular irritability
- C. Excessive thirst
- D. Acute gastritis
Correct Answer: B
Rationale: Hypoparathyroidism is a condition characterized by decreased levels of parathyroid hormone, which can lead to low levels of calcium in the blood (hypocalcemia). Profound neuromuscular irritability is a significant complication of hypocalcemia and is a key concern for clients with hypoparathyroidism. Symptoms can include muscle cramps, tetany, seizures, and decreased cardiac contractility. Monitoring for neuromuscular irritability and promptly addressing low calcium levels are essential in the care of clients with hypoparathyroidism.
A healthy 20-day-old male examination reveals a palpable liver margin below the right costal margin; lab findings: white blood count, 18700/mm3; hemoglobin, 8.8 g/dl; blast cells, 10%; the BEST approach for the management is consistent with acute myeloproliferative disorder
- A. intensive chemotherapy
- B. low dose chemotherapy pulses
- C. bone marrow transplantation
- D. close follow up
Correct Answer: A
Rationale: Intensive chemotherapy is the standard approach for managing acute myeloproliferative disorders.
The nurse explains to a client that she will administer his first insulin dose in his abdomen. How does absorption at the abdominal site compare to absorption at other sites?
- A. Insulin is absorbed more slowly at abdominal injection sites than at other sites.
- B. Insulin absorbed rapidly regardless of the injection site.
- C. Insulin is absorbed more rapidly at abdominal injection than at other sites.
- D. Insulin is absorbed unpredictably at all injection sites.
Correct Answer: C
Rationale: Insulin absorption rates can vary depending on the injection site. The abdomen is one of the recommended sites for insulin injection due to its relatively rapid absorption rate compared to other sites such as the upper arm or thigh. Insulin injected into the abdomen is absorbed more quickly because of the larger blood supply in that area, leading to faster onset of action and better blood glucose control. This is why the nurse chose to administer the first insulin dose in the client's abdomen for optimal effectiveness.
A client with human immunodeficiency virus (HIV) undergoes intradermal anergy testing using Candida and mumps antigen. During the 3 days following the tests, there is no induration or evidence of reaction at the intradermal injection sites. The most accurate conclusion the nurse can make is:
- A. The client has no previous exposure to the antigens injected
- B. The results demonstrate the client has antibodies to the antigens
- C. The client is immunodeficient and won't have a skin response
- D. The client isn't allergic to the antigens and therefore doesn't react
Correct Answer: C
Rationale: A client with HIV undergoing intradermal anergy testing with Candida and mumps antigens is suspected to be immunodeficient, making them unable to mount a normal skin response to these antigens. In an immunodeficient individual, the immune system is weakened, leading to a lack of response when exposed to these antigens. A lack of induration or reaction in the 3 days following the test suggests that the client's immune system is not able to mount a normal response, indicating immunodeficiency. The absence of a reaction does not necessarily indicate lack of exposure (Option A), presence of antibodies (Option B), or the absence of allergies (Option D), but rather points to a compromised immune system in an individual with HIV.