Nokea
The nurse is teaching a client with a new diagnosis of type 1 diabetes about insulin glargine (Lantus). Which of the following statements by the client indicates a need for further teaching?
- A. I should take this insulin at bedtime.
- B. I should not mix this insulin with other insulins.
- C. I should rotate injection sites.
- D. I should take this insulin when my blood sugar is high.
Correct Answer: D
Rationale: Taking insulin glargine when blood sugar is high is incorrect, as it is a long-acting basal insulin for steady control, not for acute hyperglycemia. Options A, B, and C are correct: bedtime dosing is standard, it should not be mixed, and rotation prevents lipodystrophy.
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A 38-year-old woman, mother of two, has a mastectomy for breast cancer.
- A. Which client response one month after a mastectomy indicates a normal reaction to the surgery?
- B. I have been helping my family deal with their feelings about the surgery.'
- C. I have been having difficulty coping with the surgery and cry frequently.'
- D. I have been unable to leave the house or talk to my friends about the surgery.'
- E. I am doing just great since the surgery and have gone back to work at my job.'
Correct Answer: B
Rationale: Frequent crying and difficulty coping one month post-mastectomy reflect a normal grieving process for the loss of a body part. Helping family cope is premature, social withdrawal indicates abnormal adjustment, and immediate return to normal activities suggests denial, which is too early for integration.
The nurse is caring for a client who is receiving chemotherapy and has a platelet count of 50,000/mm^3. Which of the following actions is the PRIORITY?
- A. Administer pain medication as needed.
- B. Monitor for signs of bleeding.
- C. Encourage the client to ambulate.
- D. Provide a soft diet.
Correct Answer: B
Rationale: A platelet count of 50,000/mm^3 indicates thrombocytopenia, increasing bleeding risk. Monitoring for bleeding (e.g., petechiae, hematomas) is the priority to detect complications early. Options A, C, and D are secondary: pain management, ambulation, and diet are less urgent.
The nurse is caring for a client with a history of depression who is receiving bupropion (Wellbutrin) 150 mg PO bid. Which of the following client statements would be of GREATest concern to the nurse?
- A. I have a dry mouth.
- B. I feel restless sometimes.
- C. I think about ending my life.
- D. I take my medication with food.
Correct Answer: C
Rationale: Thoughts of ending life indicate suicidal ideation, a medical emergency requiring immediate intervention in a client on bupropion. Options
A Jewish client requires grafting to promote burn healing. Which graft is most likely to be unacceptable to the client?
- A. Isograft
- B. Autograft
- C. Homograft
- D. Xenograft
Correct Answer: D
Rationale: A Jewish client may find a xenograft unacceptable due to religious dietary laws that prohibit the use of certain animal products, such as porcine grafts. An isograft (from an identical twin), autograft (from the client's own body), and homograft (from a human donor) are generally more acceptable. Answers A, B, and C are incorrect because they do not typically conflict with Jewish religious beliefs.
A 5-year-old child has been treated for sickle cell crisis. The parent asks the nurse if there is anything that can be done to prevent future crises. What should be included in the nurse's response?
- A. Sickle crisis is hard to predict and not usually preventable.
- B. Keeping the child from getting chilled may prevent a crisis.
- C. Fevers, vomiting, and diarrhea should be reported to the physician immediately.
- D. Giving the child aspirin on a daily basis lessens the frequency of crises.
Correct Answer: C
Rationale: Fevers, vomiting, and diarrhea can trigger sickle cell crisis by causing dehydration or infection, so prompt reporting allows early intervention to prevent crises.