Nokea
The nurse is analyzing laboratory values for the assigned clients. Which finding, based on the client's medical history, indicates the need for immediate follow-up?
- A. Client with chronic kidney disease and serum creatinine of 1.6 mg/dL
- B. Client with diabetes mellitus and a glycosylated hemoglobin A (HbA1c) of 7.0%
- C. Client with heart failure and a B-type natriuretic peptide (BNP) of 140 pg/mL
- D. Client who is male and has anemia with hemoglobin of 16.5 g/dL and hematocrit of 45%
Correct Answer: B
Rationale: An HbA1c of 7.0% in a client with diabetes mellitus indicates poor long-term glucose control, necessitating immediate follow-up. Elevated HbA1c levels suggest a higher average blood sugar over the past 2-3 months, increasing the risk of complications associated with diabetes. Choices A, C, and D do not require immediate follow-up based solely on the provided information. A serum creatinine of 1.6 mg/dL in a client with chronic kidney disease, a BNP of 140 pg/mL in a client with heart failure, and hemoglobin of 16.5 g/dL and hematocrit of 45% in a male client with anemia are within acceptable ranges or do not indicate an urgent need for intervention.
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Which drugs contribute to peptic ulcers?
- A. Antacids
- B. Certain antibiotics
- C. Cholesterol-lowering medications
- D. Nonsteroidal anti-inflammatory drugs
Correct Answer: D
Rationale: Nonsteroidal anti-inflammatory drugs (NSAIDs) are known to contribute to the development of peptic ulcers by affecting the protective lining of the stomach and increasing stomach acid production. This can lead to irritation and ulcer formation. Antacids are actually used to relieve symptoms of peptic ulcers by neutralizing stomach acid. Certain antibiotics may be prescribed to treat H. pylori infection, a common cause of peptic ulcers. Cholesterol-lowering medications are not typically associated with causing peptic ulcers.
Who typically collects blood specimens?
- A. The nurse
- B. Medical technologist
- C. Physician
- D. Pharmacist
Correct Answer: A
Rationale: Nurses typically collect blood specimens from patients as part of their everyday duties in medical settings. They are trained in venipuncture techniques and are responsible for ensuring that blood samples are properly obtained and labeled for diagnostic testing. Medical technologists process and analyze the blood specimens in the laboratory under the direction of a physician, but the actual collection of specimens is commonly performed by nurses. Physicians are primarily responsible for diagnosing and treating medical conditions rather than collecting blood specimens. Pharmacists are healthcare professionals who specialize in medication management and dispensing, not in collecting blood specimens.
A patient with Crohn's disease is experiencing diarrhea. Which dietary recommendation is appropriate?
- A. High-fiber diet
- B. Low-residue diet
- C. High-fat diet
- D. High-protein diet
Correct Answer: B
Rationale: A low-residue diet is appropriate for a patient with Crohn's disease experiencing diarrhea because it helps reduce bowel movements and manage symptoms. Choice A, a high-fiber diet, can exacerbate diarrhea in Crohn's disease due to increased bulk and fermentation in the gut. Choice C, a high-fat diet, may be hard to digest and can worsen symptoms. Choice D, a high-protein diet, can be taxing on the digestive system and may not provide the relief needed for diarrhea in Crohn's disease.
The nurse in the pediatric clinic performs a physical assessment of a 13-year-old boy. Which of the following findings by the nurse requires immediate intervention?
- A. The adolescent complains of his scrotum aching after exercise. The nurse palpates a worm-like mass above the testes.
- B. The nurse noted unilateral breast enlargement.
- C. The child's scrotum appears swollen, and a soft mass is palpated. The nurse is unable to insert a finger above the mass.
- D. The child's scrotum appears enlarged and red. The nurse palpated a thickened and swollen spermatic cord.
Correct Answer: D
Rationale: Choice D is the correct answer because a swollen and thickened spermatic cord could indicate testicular torsion, which is a surgical emergency. Testicular torsion occurs when the spermatic cord twists, cutting off the blood supply to the testicle. This condition requires immediate intervention to prevent testicular damage. Choices A, B, and C do not present findings that suggest a surgical emergency requiring immediate intervention.
The client diagnosed with Type 2 diabetes mellitus is being taught about diet by the nurse. Which diet selection indicates the client understands the teaching?
- A. A submarine sandwich, potato chips, and diet cola
- B. Four (4) slices of a supreme thin-crust pizza and milk
- C. Smoked turkey sandwich, celery sticks, and unsweetened tea
- D. A roast beef sandwich, fried onion rings, and a cola
Correct Answer: C
Rationale: The correct answer is C because a smoked turkey sandwich with celery sticks and unsweetened tea reflects a balanced and healthy choice suitable for a client with Type 2 diabetes mellitus. Turkey is a lean protein choice, celery sticks offer fiber and low calories, and unsweetened tea is a sugar-free beverage. Choices A, B, and D are incorrect as they include high-carb, high-fat, and sugary options that are not recommended for individuals with diabetes as they can spike blood sugar levels.