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The nurse is talking with a client who has type 1 diabetes mellitus and is receiving newly prescribed continuous subcutaneous insulin infusion therapy via an infusion pump. Which of the following statements by the client would indicate a correct understanding of the therapy?
- A. I will no longer need to test my blood glucose level throughout the day.
- B. I will no longer require an extra dose of insulin before my meals.
- C. My blood glucose levels should be more consistent throughout the day.
- D. The infusion set of my insulin pump should be changed daily.
Correct Answer: C
Rationale: Insulin pumps (C) provide steady insulin delivery, improving glucose stability. Glucose monitoring (A) and bolus doses (B) are still needed, and infusion sets are changed every 2-3 days, not daily (D).
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The nurse is reinforcing teaching to parents about childhood nutrition and feeding practices. The nurse recognizes that which snack is best for a toddler?
- A. 1/2 cup orange juice
- B. Dry, sweetened cereal
- C. Raw carrot sticks
- D. Slice of cheese
Correct Answer: D
Rationale: A slice of cheese (D) is a nutrient-dense, easy-to-chew snack suitable for a toddler, providing protein and calcium. Orange juice (A) is high in sugar, sweetened cereal (B) lacks nutritional value, and raw carrot sticks (C) pose a choking hazard.
The nurse in the emergency department is caring for a client who has facial lacerations, a suspected fracture of the arm, and multiple bruises at various stages of healing. The client's spouse is at the bedside and appears angry. Which of the following actions would be a priority for the nurse take?
- A. Recommend a referral to social services for the client.
- B. Talk with the client privately without the spouse in the room.
- C. Place the client's arm in a shoulder sling and prepare the client for an x-ray.
- D. Cleanse the client's facial lacerations and prepare to assist with suture placement.
Correct Answer: B
Rationale: Multiple bruises at various stages suggest possible abuse, so talking privately with the client (B) is the priority to assess safety. Social services (A) may follow, but immediate safety assessment comes first. Treating injuries (C, D) is secondary.
An 87-year-old client has been admitted to the hospital with signs and symptoms of a urinary tract infection along with agitation, confusion, and disorientation to time and place. What is the most important nursing action?
- A. Encouraging frequent fluid intake
- B. Keeping the bed elevated and side rails raised
- C. Providing one-on-one supervision
- D. Turning the lights off in the client's room
Correct Answer: C
Rationale: One-on-one supervision (C) ensures safety for a confused, agitated client at risk for falls or harm. Fluids (A), side rails (B), and dim lights (D) are secondary or inappropriate.
An 80-year-old client is prescribed codeine for a severe cough. The home health nurse is reinforcing instructions on how to prevent the common adverse effects associated with codeine. Which client statements indicate an understanding of how to prevent them? Select all that apply.
- A. I'll be sure to apply sunscreen if I go outside.
- B. I'll drink at least 8 glasses of water a day.
- C. I'll drink decaffeinated coffee so I can sleep at night.
- D. I'll sit on the side of my bed for a few minutes before getting up.
- E. I'll take my medicine with food.
Correct Answer: B,D,E
Rationale: Drinking water (B) prevents constipation, sitting before standing (D) avoids orthostatic hypotension, and taking with food (E) reduces nausea. Sunscreen (A) and decaf coffee (C) are unrelated to codeine effects.
While assisting a doctor with a sterile dressing change, the nurse notices that the doctor has contaminated his left hand. Which action should the nurse take?
- A. Hand the doctor another pair of gloves.
- B. Tell the doctor that he has contaminated his gloves.
- C. Say nothing because the client will be placed on prophylactic antibiotics.
- D. Report the incident to the infection control nurse.
Correct Answer: B
Rationale: Telling the doctor about the contamination maintains sterility and patient safety. Handing gloves assumes he noticed. Antibiotics are not a substitute for sterility. Reporting is secondary to immediate action.