Nokea
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.
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Mr. Reyes is extremely confused. The nurse provide new information slowly and in small amounts because;
- A. Confusion or delirium can be a defense against further stress
- B. Destruction of brain cells has occurred, interrupting mental activity
- C. Teaching based on information progressing from the simple to the complex
- D. A minimum of information should be given, since he is unaware of surrounding
Correct Answer: A
Rationale: Providing new information slowly and in small amounts to a confused individual, like Mr. Reyes, is important because confusion or delirium can be a defense mechanism against further stress. By giving information gradually, it allows the individual to better absorb and process the information without becoming overwhelmed, which can further exacerbate their confusion. This approach also helps reduce the risk of causing additional stress or agitation in the individual, thus promoting a more conducive environment for cognitive processing and understanding.
Many factors in nasopharyngeal carcinoma patients may affect the prognosis. Which of the following carries the worst outcome?
- A. elevated lactate dehydrogenase (LDH) level
- B. advanced disease
- C. extensive cervical lymph node involvement
- D. evidence of Epstein-Barr virus (EBV) DNA
Correct Answer: A
Rationale: Elevated LDH levels are strongly associated with aggressive disease and poor prognosis.
Which is an important nursing consideration when caring for an infant with failure to thrive?
- A. Establish a structured routine and follow it consistently.
- B. Maintain a nondistracting environment by not speaking to child during feeding.
- C. Place child in an infant seat during feedings to prevent overstimulation.
- D. Limit sensory stimulation and play activities to alleviate fatigue.
Correct Answer: A
Rationale: Establishing a structured routine and following it consistently is an important nursing consideration when caring for an infant with failure to thrive. Infants with failure to thrive often struggle with feeding, growth, and development. By providing a structured routine, you can create a predictable environment that can help promote the infant's overall well-being. Consistency in feeding times, nap times, and play times can help establish a sense of security and stability for the infant. This routine can also support proper feeding patterns, which are essential for addressing the infant's nutrition needs and promoting growth and development.
Which gauge IV cannula should the nurse choose when preparing to initiate a blood transfusion?
- A. 18
- B. 24
- C. 22
- D. 28
Correct Answer: A
Rationale: An 18-gauge IV cannula is the most appropriate choice when preparing to initiate a blood transfusion. This larger size allows for the rapid administration of blood products, which is important to prevent clotting and ensure a stable flow of the transfusion. Smaller gauge sizes, such as 22, 24, or 28, may be too slow for transfusion purposes and could potentially lead to delays or complications during the procedure. Therefore, the optimal choice for initiating a blood transfusion is an 18-gauge IV cannula.
A nurse is planning care for a preterm newborn. Which interventions should the nurse implement for skin care? (Select all that apply.)
- A. Use cleaning agents with neutral pH.
- B. Rub skin during drying.
- C. Use adhesive remover solvent when removing tape.
- D. Avoid removing adhesives for at least 24 hours.
Correct Answer: A
Rationale: Using cleaning agents with neutral pH is important for the delicate skin of a preterm newborn to prevent irritation and damage.