Nokea
The nurse is attending a workshop about caring for persons infected with hepatitis. Which characteristic is most appropriate when defining the incidence rate of hepatitis?
- A. The number of persons in a population who develop hepatitis B during a specific period of time
- B. The total number of persons in a population who have hepatitis B at a particular time
- C. The percentage of deaths resulting from hepatitis B during a specific time
- D. The occurrence of hepatitis B in the population at a particular time
Correct Answer: A
Rationale: The number of persons in a population who develop hepatitis B during a specific period of time. This is the correct definition of incidence of the disease.
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An adult has both an oil retention enema and a cleansing enema ordered. The nurse knows that this client is most likely to have which condition/ problem?
- A. Straining while defecating
- B. Melena
- C. Ulcerative colitis
- D. Fecal impaction
Correct Answer: D
Rationale: Oil retention enemas soften hardened stool, and cleansing enemas remove it, making this combination most appropriate for fecal impaction. Straining, melena, or ulcerative colitis are less likely to require both types of enemas.
A primigravida begins labor when her family is unavailable and she is alone. She is very upset that her family is not with her. Which approach can the nurse take to meet the client's needs at this time?
- A. asking whether another individual wants to be her support person
- B. assuring her that the nursing triage group will be with her at all times
- C. telling her you will try to locate her family
- D. reinforcing the woman's confidence in her own abilities to cope and maintain a sense of control
Correct Answer: A
Rationale: Allow the client to select another individual to give support. This allows her to have someone with her until her family can be with her.
The client is scheduled for a glucose tolerance test. Place in ordered response the correct sequence for performance of this test.
- A. Instruct the client to drink a 75 gm glucose solution.
- B. Tell the client to eat a high carbohydrate diet for three days prior to the exam.
- C. Instruct the client to remain NPO after midnight.
- D. Obtain a fasting blood glucose level.
- E. Obtain a two-hour post-prandial glucose level.
Correct Answer: B,C,D,A,E
Rationale: When placing in chronological order, the nurse should: tell the client to increase the amount of carbohydrates for three days prior to the exam; instruct the client to remain NPO after midnight the day of the exam; obtain a fasting blood glucose level; instruct the client to drink a 75 gm glucose solution; and obtain a two-hour post-prandial glucose level. The candidate is asked to place answers in a logical sequence. Think about the natural order of the question.
Exhibit 1
Medication administration record
Allergies: No known drug allergies
Medication Time
Insulin NPH: 75 units subcutaneously, twice daily 0800, 2000
Insulin lispro: sliding scale dosing, before meals and at bedtime 0800, 1130, 1730, 2100
Exhibit 2
Laboratory results and reference ranges
Sodium
136-145 mEq/L
(136-145 mmol/L) 141 mEq/L
(141 mmol/L)
Potassium
3.5-5.0 mEq/L
(3.5-5.0 mmol/L) 3.0 mEq/L
(3.0 mmol/L)
Glucose (fasting)
70-110 mg/dL
(3.9-6.1 mmol/L) 328 mg/dL
(18.2 mmol/L)
The nurse is preparing to administer medications scheduled for 0800 to a client with type 1 diabetes mellitus. After reviewing the client's morning laboratory test results, which of the following actions would be a priority for the nurse to take?
- A. Administer insulin lispro per protocol and insulin NPH
- B. Contact the client's health care provider
- C. Obtain a urine specimen to check for ketones
- D. Recheck the client's capillary blood glucose level
Correct Answer: B
Rationale: Abnormal lab results (e.g., severe hypo/hyperglycemia) require provider notification to adjust treatment. Administering insulin, checking ketones, or rechecking glucose are secondary without specific lab values.
The nurse is reinforcing discharge teaching for a client who had aortic valve replacement with a mechanical heart valve. Which statement by the client indicates that teaching has been effective?
- A. I'm glad that I can continue taking my Ginkgo biloba.
- B. I will increase my intake of leafy green vegetables
- C. I will start applying vitamin E to my chest incision after showering
- D. I will shave with an electric razor from now on
Correct Answer: D
Rationale: Mechanical prosthetic valves are more durable than biological valves but require long-term anticoagulation therapy due to the increased risk of thromboembolism. The client should be taught ways to reduce the risk of bleeding.