Nokea
The nurse is caring for a client with Cushing syndrome. Which of the following clinical manifestations should the nurse expect? Select all that apply.
- A. Hyperglycemia
- B. Hypertension
- C. Hyponatremia
- D. Truncal obesity
- E. Weight loss
Correct Answer: A,B,D
Rationale: Cushing syndrome causes hyperglycemia, hypertension, and truncal obesity due to excess cortisol. Hyponatremia and weight loss are not typical.
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The nurse is preparing to administer an enteral feeding to a client via a nasogastric feeding tube. The most important action of the nurse is to
- A. verify correct placement of the tube
- B. check that the feeding solution matches the dietary order
- C. aspirate abdominal contents to determine the amount of last feeding remaining in stomach
- D. ensure that feeding solution is at room temperature
Correct Answer: A
Rationale: verify correct placement of the tube. Proper placement of the tube prevents aspiration.
The nurse notes that a client with COPD demonstrates increased dyspnea in certain positions. Which position is most likely to lessen the client's dyspnea?
- A. Lying supine with a single pillow
- B. Standing or sitting upright
- C. Side lying with the head elevated
- D. Lying with head slightly lowered
Correct Answer: B
Rationale: The client with chronic obstructive pulmonary disease has increased difficulty breathing when lying down. His respiratory effort is improved by standing or sitting upright or by having the bed in high Fowler's position. Answers A, C, and D do not alleviate the client's dyspnea; therefore they are incorrect.
The nurse caring for newborns observes for jaundice. Which type of jaundice is likely to be most serious?
- A. Jaundice that occurs during the first day of life
- B. Jaundice occurring after 48 hours of life
- C. Jaundice occurring 7 to 10 days after birth
- D. Any jaundice is potentially life threatening.
Correct Answer: A
Rationale: Jaundice within the first 24 hours suggests pathological causes like hemolytic disease, requiring urgent evaluation. Later jaundice is often physiologic and less severe.
The nurse is talking with a client with rheumatoid arthritis who has a new prescription for adalimumab. Which of the following statements by the client would require follow-up?
- A. I usually take naproxen for pain twice a week
- B. I received my annual influenza vaccine injection 3 weeks ago.
- C. I received a negative test result for my tuberculin skin test one week ago.
- D. I started a course of antibiotic therapy to treat a urinary tract infection 2 days ago.
Correct Answer: D
Rationale: Adalimumab, an immunosuppressant, increases infection risk. Starting antibiotics for an active infection requires follow-up to ensure the infection is resolved before initiating adalimumab. The other statements are not concerning.
A woman who has been hospitalized for several days says she is having trouble getting to sleep. What is the best initial nursing intervention?
- A. Offer her a back rub.
- B. Ask her what she is worrying about.
- C. Give the ordered PRN sedative.
- D. Notify the physician.
Correct Answer: A
Rationale: A back rub promotes relaxation non-pharmacologically, addressing insomnia safely. Asking about worries, giving sedatives, or notifying the physician are less immediate.