Nokea
The nurse has attended a continuing education presentation about acid-base imbalances. It would indicate a correct understanding of the conference if the nurse identifies which of the following conditions may cause the ABG in the exhibit.
- A. Five-day history of severe diarrhea
- B. Hyperemesis gravidarum
- C. End-stage renal disease (ESRD)
- D. Diabetic ketoacidosis (DKA)
- E. Chronic obstructive pulmonary disease (COPD)
- F. Hyperglycemic hyperosmolar nonketotic syndrome (HHNS)
Correct Answer: A, B, D, F
Rationale: Severe diarrhea, hyperemesis gravidarum, DKA, and HHNS can cause metabolic acidosis, as indicated by a low pH and low bicarbonate on ABG.
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The nurse is caring for a client who is edentulous. Which of the following diet orders should the nurse request from the healthcare provider?
- A. a low sodium diet
- B. a mechanical soft diet
- C. a renal diet
- D. a high-fiber diet
Correct Answer: B
Rationale: A mechanical soft diet is appropriate for an edentulous client to ensure safe chewing and swallowing.
The nurse is performing a physical assessment on a newborn. The nurse assessed 3+ brachial pulses, cold and pale feet, decreased capillary refill time in the feet, and warm and pink hands. Which cardiac disease process do these assessment findings support?
- A. Tetralogy of Fallot (TOF)
- B. Hypoplastic left heart syndrome
- C. Coarctation of the aorta (COA)
- D. Transposition of the great arteries
Correct Answer: C
Rationale: These findings suggest coarctation of the aorta, with reduced lower extremity perfusion due to aortic narrowing.
The nurse is teaching a class on substance use disorders. It would be correct for the nurse to characterize physical dependence as
- A. obsessive desire for the euphoric effects of a drug
- B. a need for a drug to avoid physical withdrawal symptoms
- C. severe effects that may be life-threatening
- D. unpleasant symptoms related to the absence of a drug
Correct Answer: B
Rationale: Physical dependence is defined as needing a drug to avoid withdrawal symptoms.
The nurse is caring for a client three hours postpartum after delivering a term newborn infant. Which assessment finding would indicate an early sign of postpartum hemorrhage?
- A. Heart rate change from 80 to 125 bpm
- B. Blood pressure change from 125/90 to 119/82 mmHg
- C. A decrease in respiratory rate from 22 to 16 breaths per minute
- D. Saturation of one peri-pad since delivery
Correct Answer: A
Rationale: Tachycardia (heart rate increase to 125 bpm) is an early sign of postpartum hemorrhage due to compensatory response to blood loss.
The emergency department (ED) nurse cares for a child with epistaxis. Place the following actions in the order in which they need to be performed, starting from first to last.
- A. Apply ice or a cold cloth to the bridge of the nose if the bleeding persists.
- B. Apply continuous pressure to the tip of the nose with thumb and forefinger for at least 10 minutes.
- C. Provide the child with a drink to wash away the taste of blood.
- D. Have the child sit up with the neck forward or erect.
- E. Evaluate the bleeding to determine the effectiveness of the interventions.
Correct Answer: D, B, A, E, C
Rationale: Correct order: Sit upright, apply pressure, apply ice if needed, evaluate bleeding, provide a drink last.