Nokea
The nurse is caring for a client with type 2 diabetes who has been hospitalized with severe hyperglycemia. Which of the following topics will be most important to include in discharge teaching?
- A. Effect of endogenous insulin on transportation of glucose into cells
- B. Function of the liver in formation of glycogen and gluconeogenesis
- C. Impact of the client's family history on likelihood of developing diabetes
- D. Symptoms indicating that the client should contact the health care provider
Correct Answer: D
Rationale: Discharge teaching for type 2 diabetes post-hyperglycemia hinges on crisis prevention knowing when symptoms like thirst or confusion scream for help beats insulin mechanics, liver roles, or family odds. Clients need actionable cues to self-manage, not just theory; recognizing trouble and calling in keeps them out of the ER. Physiology's useful, genetics informative, but spotting escalation's life-saving, a chronic care must nurses drill into patients for real-world control.
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The signs and symptoms of heart failure include:
- A. Polyphagia and polydipsia.
- B. Orthopnoea and gastrointestinal disruption.
- C. Urinary frequency and acute pulmonary oedema.
- D. Dyspnoea and peripheral oedema.
Correct Answer: D
Rationale: Heart failure (HF) manifests through circulatory and fluid overload effects. Polyphagia and polydipsia align with diabetes, not HF. Orthopnoea (breathlessness lying flat) is HF-specific, but gastrointestinal disruption (e.g., nausea) is secondary, less hallmark. Urinary frequency occurs nocturnally in HF (nocturia), but acute pulmonary edema is an acute crisis, not a chronic sign. Dyspnoea (shortness of breath) from pulmonary congestion and peripheral edema (swelling) from venous backup are classic, per Farrell (2017) reflecting left and right HF respectively. These stem from reduced cardiac output and fluid retention (e.g., elevated jugular venous pressure), driving clinical presentation. Dyspnoea limits activity, edema signals systemic impact, making them definitive over less specific or acute-only symptoms.
The nurse administers an IV vesicant chemotherapeutic agent to a patient. Which action is most important for the nurse to take?
- A. Infuse the medication over a short period of time.
- B. Stop the infusion if swelling is observed at the site.
- C. Administer the chemotherapy through a small-bore catheter.
- D. Hold the medication unless a central venous line is available.
Correct Answer: B
Rationale: Vesicants (e.g., vincristine) burn tissue if they leak swelling at the site yells extravasation; stopping the IV stat limits necrosis. Fast infusion ups vein stress; small-bore risks rupture running IVs dilute it. Central lines are gold but not mandatory. Nurses in oncology prioritize this catching leaks early saves skin, a critical save in chemo land.
How do you treat secondary syphilis?
- A. oral penicillin
- B. i.m. penicillin
- C. i.v. penicillin
- D. erythromycin
Correct Answer: B
Rationale: Secondary syphilis IM penicillin blasts treponemes, not oral, IV, or erythro sidesteps. Nurses shoot this chronic cure.
The nurse obtains information about a hospitalized patient who is receiving chemotherapy for colorectal cancer. Which information about the patient alerts the nurse to discuss a possible change in therapy with the health care provider?
- A. Poor oral intake
- B. Frequent loose stools
- C. Complaints of nausea and vomiting
- D. Increase in carcinoembryonic antigen (CEA)
Correct Answer: D
Rationale: Colorectal cancer's chemo tracks via CEA rising levels signal progression or resistance, a red flag for therapy tweak, needing provider input. Poor intake, diarrhea, and nausea are side effects, manageable with nursing care diet, fluids, antiemetics unless extreme. CEA's uptick, a tumor marker, trumps symptoms, hinting at disease outpacing treatment. Nurses flag this, pushing for scans or regimen shifts, a critical catch in this cancer's chemo dance.
Which of the following is a priority nursing intervention for a client in atrial fibrillation with a rate of 180 beats per minute?
- A. Apply compression stockings
- B. Administer medications to slow the rate
- C. Administer anticoagulants
- D. Monitor urine output
Correct Answer: B
Rationale: AF at 180 bpm tanks output meds like beta-blockers or amiodarone slow it, restoring flow, a priority per ABCs over stockings' vein aid. Anticoagulants curb clots later; urine's secondary. Nurses push rate control, steadying this wild heart, a critical fix in this tachycardic storm.