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The nurse's neighbor has a total cholesterol of 450 mg/dL. The neighbor asks the nurse what this means. What should the nurse include when responding?
- A. The cholesterol level is slightly high, but exercise and a low-fat diet should reduce it to normal.
- B. The cholesterol level is below normal levels, but this is good.
- C. The cholesterol level is high. The neighbor should talk with the physician about ways to lower it.
- D. The cholesterol is within normal limits.
Correct Answer: C
Rationale: A cholesterol level of 450 mg/dL is significantly elevated, increasing cardiovascular risk, requiring medical consultation.
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The nurse is reinforcing discharge teaching for a client who has a low health literacy level. Which of the following actions should the nurse take? Select all that apply.
- A. Provide as much detail as possible.
- B. Utilize the teach-back method.
- C. Repeat important information.
- D. Use visual aids.
- E. Speak loudly.
Correct Answer: B,C,D
Rationale: Teach-back confirms understanding, repeating key points reinforces learning, and visual aids simplify concepts. Excessive detail overwhelms low-literacy clients, and loud speech is unnecessary unless hearing-impaired.
Medication administration record
Allergies: No Known Allergies
Sliding scale blood glucose levels, regular insulin dose
<150 mg/dL (<8.3 mmol/L), O units
150-199 mg/dL (8.3-11.0 mmol/L), 2 units
200-249 mg/dL (11.1-13.8 mmoV/L), 4 units
250-299 mg/dL (13.9-16.6 mmol/L), 6 units
≥300 mg/dL (≥16.7 mmol/L), 8 units and notify health care provider
A client with type 1 diabetes has a prescription for 30 units of insulin glargine at bedtime. Fingerstick blood glucose measurements are prescribed before meals and at bedtime with regular insulin based on a sliding scale. At 9 PM, the client's blood glucose measurement is 180 mg/dL (10.0 mmol/L). What action should the nurse take?
- A. Administer 30 units of glargine; give the client a snack, then administer 2 units of regular insulin
- B. Administer 30 units of glargine and 2 units of regular insulin in 2 different injections
- C. Mix 30 units of glargine with 2 units of regular insulin in the same syringe, drawing up the glargine first
- D. Mix 30 units of glargine with 2 units of regular insulin in the same syringe, drawing up the regular insulin first
Correct Answer: B
Rationale: The sliding scale indicates 2 units of regular insulin for a glucose of 180 mg/dL. Glargine, a long-acting insulin, should be given as prescribed (30 units). Glargine cannot be mixed with regular insulin in the same syringe due to differing pH levels, so separate injections are required.
The nurse is caring for a client with Cushing's syndrome. The nurse should carefully assess the client for signs of:
- A. Hypoglycemia
- B. Infection
- C. Hypovolemia
- D. Hyperinsulinemia
Correct Answer: B
Rationale: Cushing's syndrome causes immunosuppression, increasing infection risk . Hypoglycemia , hypovolemia , and hyperinsulinemia are not primary concerns.
A client on the psychiatric unit does not get to the dining room to eat because she is continually washing her hands and doesn't finish until after lunch. What should be included in the nursing care plan?
- A. Give the client a choice between eating lunch and performing her ritual.
- B. Tell the client an hour before lunch so she can perform her ritual before lunch.
- C. Discuss the problem with the client and ask her why she washes her hands so long.
- D. Tell the client she cannot wash her hands at all if she is going to be late for lunch.
Correct Answer: B
Rationale: Advance notice allows the client with OCD to complete rituals before lunch, facilitating nutrition without confrontation. Choices, discussions, or bans are less effective.
The practical nurse is collaborating with the registered nurse to admit a client who will receive general anesthesia in the same-day surgery unit. The client has never had surgery before. Which question is most critical for the nurse to ask the client during preoperative assessment and health history taking?
- A. Has any family member ever had a bad reaction to general anesthesia?
- B. Have you ever experienced low back pain?
- C. Have you ever had an anaphylactic reaction to a bee sting?
- D. Have you ever received opioid pain medications?
Correct Answer: A
Rationale: A family history of adverse reactions to anesthesia (e.g., malignant hyperthermia) is critical, as it's a potentially fatal genetic condition. Other questions are less urgent for anesthesia safety.