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The nurse should explain to a client that tolbutamide (Orinase) is effective for diabetics who
- A. can no longer produce any insulin.
- B. produce minimal amounts of insulin.
- C. are unable to administer their injections.
- D. have a sustained decreased blood glucose.
Correct Answer: B
Rationale: Tolbutamide, an oral hypoglycemic, is effective for type 2 diabetes patients who produce minimal insulin, stimulating insulin release. Type 1 diabetics (A) produce no insulin, injection inability (C) is irrelevant, and low blood glucose (D) is not an indication for tolbutamide.
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The nurse is caring for a client with a history of schizophrenia who is experiencing auditory hallucinations. Which of the following interventions is MOST appropriate?
- A. Argue with the client about the reality of the voices.
- B. Encourage the client to listen to music with headphones.
- C. Instruct the client to ignore the voices completely.
- D. Administer an antipsychotic medication as ordered.
Correct Answer: B
Rationale: Listening to music with headphones can distract from auditory hallucinations, reducing their intensity. Arguing (A) increases agitation, ignoring voices (C) is ineffective, and administering medication (D) is appropriate but not the most immediate non-pharmacologic intervention.
A 4-year-old child with Down syndrome is admitted to the hospital with pneumonia. She has a heart murmur and appears to be in respiratory distress. Her mother asks why her child has a heart murmur. What is the best nursing response?
- A. Because she has pneumonia, her heart is working harder and causes the murmur.'
- B. Heart murmurs come and go in children. It is not a great concern.'
- C. Because of the pneumonia, her ductus arteriosus is functioning again.'
- D. Heart defects are common in children with Down syndrome. Her illness may make the murmur louder.'
Correct Answer: D
Rationale: Congenital heart defects, like ventricular septal defects, are common in Down syndrome, and pneumonia may amplify a murmur due to increased cardiac workload.
The problem with sensory recognition is called
The problem with sensory recognition is called
- A. Aphasia
- B. Apraxia
- C. Agnosia
- D. Dysarthia
Correct Answer: C
Rationale: Agnosia is the inability to recognize sensory input, such as objects or sounds.
The client presents to the clinic with a serum cholesterol of 275 mg/dL and is placed on rosuvastatin (Crestor). Which instruction should be given to the client?
- A. Report muscle weakness to the physician.
- B. Allow six months for the drug to take effect.
- C. Take the medication with fruit juice.
- D. Ask the doctor to perform a complete blood count prior to starting the medication.
Correct Answer: A
Rationale: The client taking antilipidemics should be encouraged to report muscle weakness because this is a sign of rhabdomyolysis. The medication takes effect within one month of beginning therapy, so answer B is incorrect. The medication should be taken with water. Fruit juice, particularly grapefruit juice, can decrease the drug's effectiveness, so answer C is incorrect. Liver function studies, not a CBC, should be checked prior to beginning the medication, so answer D is incorrect.
The nurse is caring for a client with a fractured femur who is in skeletal traction. Which of the following actions is MOST important for the nurse to perform?
- A. Check the pin sites for signs of infection.
- B. Ensure the weights are hanging freely.
- C. Perform range-of-motion exercises on the affected leg.
- D. Reposition the client every 4 hours.
Correct Answer: B
Rationale: Ensuring weights hang freely maintains proper traction alignment, preventing complications like malunion. Checking pin sites (A) is important but secondary, ROM exercises (C) are contraindicated in traction, and repositioning (D) is limited to maintain traction.