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The nurse is caring for a client who has adrenal insufficiency (Addison's disease). Which of the following interventions would be a priority?
- A. Administer prescribed hydrocortisone
- B. Offer salty snacks and water
- C. Assess skin integrity
- D. Encourage frequent rest periods
Correct Answer: A
Rationale: Adrenal insufficiency causes cortisol deficiency, leading to hypotension and weakness. Administering hydrocortisone is critical to replace cortisol and stabilize the client. Salty snacks, skin checks, and rest are supportive but not the priority.
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The nurse is caring for a client who has acute pancreatitis. Based on the 11:15 AM vital signs, the nurse should prioritize which action? Click to view the exhibit for additional client information.
- A. Obtain a 12-lead electrocardiogram
- B. Assess the client for pain
- C. Apply oxygen via nasal cannula
- D. Infuse 500 ml 0.9% sodium chloride (normal saline) bolus
Correct Answer: B
Rationale: Acute pancreatitis causes severe pain, a hallmark symptom. Without vital signs data, pain assessment is the priority to guide treatment and comfort, preceding ECG, oxygen, or fluids.
The nurse is caring for a client who is receiving newly prescribed prednisone. Which of the following medications should the client avoid while receiving this medication?
- A. valsartan
- B. naproxen
- C. omeprazole
- D. acetaminophen
Correct Answer: B
Rationale: Naproxen, an NSAID, should be avoided with prednisone due to increased risk of gastrointestinal bleeding and ulceration. Valsartan, omeprazole, and acetaminophen are generally safe with prednisone, though monitoring is needed.
The nurse is planning a staff education program about conditions that increase cortisol levels. Which of the following conditions should the nurse include?
- A. Addison's disease
- B. Congestive heart failure (CHF)
- C. Renal failure
- D. Cushing's disease
Correct Answer: D
Rationale: Cushing's disease increases cortisol due to excess ACTH. Addison's reduces cortisol, and CHF and renal failure do not directly elevate cortisol levels.
The nurse is teaching a client with diabetes mellitus (type two) newly prescribed rapid-acting insulin. Which of the following information should the nurse include?
- A. Once you open your vial of insulin, discard it 25 days after opening it.
- B. Inject yourself with this insulin 20-30 minutes before meals.
- C. You can inject yourself with this insulin while you are actively eating.
- D. This insulin is administered right before you go to bed to minimize overnight blood sugar spikes.
Correct Answer: C
Rationale: Rapid-acting insulin, like lispro, can be injected just before or during meals to match carbohydrate intake. Vials are typically good for 28 days, not 25, and bedtime dosing is for long-acting insulin.
The nurse is assessing a client with a myxedema coma. Which of the following would be an expected finding?
- A. Glucose 59 mg/dL (3.28 mmol/L) [70-110 mg/d, 4.0-6.0 mmol/L]
- B. Sodium 155 mEq/L (mmol/L) [135-145 mEq/L, mmol/L]
- C. Serum pH 7.49 [7.35-7.45]
Correct Answer: A
Rationale: Myxedema coma, a severe hypothyroid state, can cause hypoglycemia due to reduced metabolism. Hypernatremia and alkalosis are not typical; hyponatremia and acidosis are more common.