Nokea
The nurse has been made aware of laboratory test results for a client who is receiving continuous cardiac monitoring. The client is asymptomatic, and the cardiac monitor shows normal sinus rhythm. Which of the following is most likely an erroneous test result?
- A. BUN of 60 mg/dL (21.4 mmol/L)
- B. serum sodium level of 155 mEq/L (155 mmol/L)
- C. serum potassium level of 7.0 mEq/L (7.0 mmol/L)
- D. serum creatinine level of 4.0 mg/dL (353.6 μmol/L)
Correct Answer: C
Rationale: A potassium level of 7.0 mEq/L (C) is life-threatening and would likely cause arrhythmias, inconsistent with normal sinus rhythm and asymptomatic status, suggesting an error. Elevated BUN (A), sodium (B), and creatinine (D) are concerning but plausible in renal or dehydration issues without immediate cardiac effects.
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A pediatric client has been receiving Amoxil (amoxicillin) for acute otitis media. It is important the child receive all the medication. Which secondary disorder is associated with improper management of acute otitis media?
- A. Cholesteatoma
- B. Mastoiditis
- C. Acoustic neuroma
- D. Presbycusis
Correct Answer: B
Rationale: Improper management of acute otitis media can lead to mastoiditis, an infection of the mastoid bone that can result from untreated or inadequately treated ear infections. Answer A (cholesteatoma) is a possible complication but less directly associated with improper antibiotic management. Answer C (acoustic neuroma) is unrelated to otitis media. Answer D (presbycusis) is age-related hearing loss, not a complication of otitis media.
The nurse reinforces education about safety modifications in the home for the spouse of a client diagnosed with Alzheimer disease. What instructions should the nurse include?
- A. Arrange furniture to allow for free movement
- B. Keep frequently used items within easy reach
- C. Lock doors leading to stairwells and outside areas
- D. Place an identifying symbol on the bathroom door
- E. Provide a dark room free of shadows for sleeping
Correct Answer: A,B,C,D
Rationale: Clear pathways (A), accessible items (B), locked doors (C), and bathroom symbols (D) enhance safety. A dark room (E) may increase confusion or fear.
An adult is admitted in severe hypovolemic shock following an auto accident. A transfusion is ordered. What type of blood is given when the client's blood type is not known?
- A. O positive
- B. O negative
- C. AB positive
- D. AB negative
Correct Answer: B
Rationale: O negative is the universal donor, safe for emergency transfusions when the blood type is unknown, minimizing reaction risk.
When reviewing the chart of a client with long standing lung disease, the nurse should pay close attention to the results of which pulmonary function test?
- A. Residual volume
- B. Total lung capacity
- C. FEV1/FVC ratio
- D. Functional residual capacity
Correct Answer: C
Rationale: The FEV1/FVC ratio indicates disease progression. As COPD worsens, the ratio of FEV1 to FVC becomes smaller. Answers A and B reflect loss of elastic recoil due to narrowing and obstruction of the airway. Answer D is increased in clients with obstructive bronchitis.
The nurse preceptor observes a graduate practical nurse collecting a urine sample for urinalysis and culture as pictured in the exhibit. What is the preceptor's best action?
- A. Advise the graduate nurse to discard the collected urine specimen and record the output
- B. Advise the graduate nurse to use a sterile specimen cup rather than a graduated container for collection
- C. Explain to the graduate nurse that midstream clean catch or straight catheterization is required
- D. Remind the graduate nurse that the specimen should be kept cool until it is sent to the laboratory
Correct Answer: C
Rationale: Urine for culture requires a midstream clean catch or catheterization (C) to avoid contamination. A graduated container (B) is acceptable if sterile. Discarding (A) is unnecessary, and cooling (D) is secondary.