Nokea
The nurse is caring for a client who is in ketoacidosis. Which blood gas values are most consistent with the diagnosis?
- A. pH=7.32, pCO2=60, HCO3=30, pO2=60
- B. pH=7.32, pCO2=32, HCO3=14, pO2=92
- C. pH=7.50, pCO2=28, HCO3=24, pO2=90
- D. pH=7.52, pCO2=50, HCO3=34, pO2=88
Correct Answer: B
Rationale: Diabetic ketoacidosis causes metabolic acidosis: low pH, low HCO3, and low pCO2 due to compensatory hyperventilation.
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An adolescent for a lumbar puncture.
It is MOST important that the nurse make which of the following statements?
- A. Don't worry because a general anesthetic will be used.'
- B. You can't drink fluids for eight hours before the Test .'
- C. You will remain flat in bed for eight hours after the Test .'
- D. A compression bandage will be in place for ten hours after the Test .'
Correct Answer: C
Rationale: Strategy: All answers are implementations. Determine the outcome of each answer choice. Is it desired? (1) general anesthetic is not used (2) fluids are not restricted before the Test (3) correct-to prevent a post-lumbar puncture headache, client should remain flat in bed for eight hours after the Test (4) inappropriate for this procedure
The nurse is caring for a client with a history of type 2 diabetes who is receiving sitagliptin (Januvia) 100 mg PO daily. Which of the following symptoms should the nurse report immediately?
- A. Mild fatigue.
- B. Upper abdominal pain.
- C. Occasional thirst.
- D. Mild headache.
Correct Answer: B
Rationale: Upper abdominal pain may indicate pancreatitis, a serious sitagliptin side effect. Options A, C, and D are less urgent.
A client admitted to the psychiatric unit claims to be the 'Son of God' and insists that he will not be confined by 'mere mortals.' The most likely explanation for the client's delusions is:
- A. A religious conversion
- B. A stressful event
- C. Low self-esteem
- D. Overwhelming anxiety
Correct Answer: C
Rationale: Delusions of grandeur, like claiming to be the 'Son of God,' often stem from low self-esteem, compensating with inflated self-perception. Religious conversion, stress, or anxiety are less likely causes.
The nurse is caring for a child with cystic fibrosis. The nurse would anticipate that the child would be deficient in which vitamins?
- A. B, D, and K
- B. A, D, and K
- C. A, C, and D
- D. A, B, and C
Correct Answer: B
Rationale: A, D, and K. The uptake of fat soluble vitamins is decreased in children with Cystic Fibrosis. Vitamins A, D, and K are fat soluble and are likely to be deficient in clients with Cystic Fibrosis.
The nurse is caring for a client with a history of pancreatitis.
- A. Which dietary instruction is most appropriate for a client with chronic pancreatitis?
- B. High-fat, low-protein diet.
- C. Low-fat, high-protein diet.
- D. High-carbohydrate, low-fat diet.
- E. Low-carbohydrate, high-fat diet.
Correct Answer: B
Rationale: A low-fat, high-protein diet reduces pancreatic stimulation and supports tissue repair in chronic pancreatitis. High-fat diets exacerbate symptoms, and carbohydrate balance is less critical.