Nokea
The provisions of the law for the Americans with Disabilities Act require nurse managers to
- A. Maintain an environment free from associated hazards
- B. Provide reasonable accommodations for disabled individuals
- C. Make all necessary accommodations for disabled individuals
- D. Consider both mental and physical disabilities
Correct Answer: B
Rationale: The law is designed to permit persons with disabilities access to job opportunities. Employers must evaluate an applicant's ability to perform the job and not discriminate on the basis of a disability. Employers also must make 'reasonable accommodations.'
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The nurse is caring for a client who is in ketoacidosis. Which blood gas values are most consistent with the diagnosis?
- A. pH=7.32, pCO2=60, HCO3=30, pO2=60
- B. pH=7.32, pCO2=32, HCO3=14, pO2=92
- C. pH=7.50, pCO2=28, HCO3=24, pO2=90
- D. pH=7.52, pCO2=50, HCO3=34, pO2=88
Correct Answer: B
Rationale: Diabetic ketoacidosis causes metabolic acidosis: low pH, low HCO3, and low pCO2 due to compensatory hyperventilation.
The nurse is caring for an adult who has kidney stones. Which action is essential for the nurse to take?
- A. Take blood pressure frequently
- B. Keep the client on bed rest
- C. Position the client supine
- D. Strain all urine
Correct Answer: D
Rationale: Straining urine captures kidney stones for analysis, guiding treatment. Blood pressure, bed rest, or positioning are not primary.
The infant of a diabetic mother has a blood glucose of 90 mg/dL and a serum calcium level of 7.0 mg/dL. The nurse should anticipate that which of the following medications would be administered IV?
- A. Insulin.
- B. Glucose.
- C. Phenobarbital.
- D. Calcium gluconate.
Correct Answer: D
Rationale: Hypocalcemia (7.0 mg/dL) in infants of diabetic mothers risks tetany; calcium gluconate is indicated. Options A, B, and C are inappropriate.
The nurse is caring for a client with a history of type 2 diabetes who is receiving exenatide (Byetta) 10 mcg SC bid. Which of the following symptoms should the nurse report immediately?
- A. Mild nausea
- B. Upper abdominal pain
- C. Occasional thirst
- D. Mild fatigue
Correct Answer: B
Rationale: Upper abdominal pain may indicate pancreatitis, a serious exenatide side effect. Options A, C, and D are less urgent: nausea is common, thirst is expected, and fatigue is nonspecific.
A client returns from surgery after an open reduction of a femur fracture. There is a small bloodstain on the cast. Four hours later, the nurse observes that the stain has doubled in size. What is the best action for the nurse to take?
- A. Call the health care provider
- B. Access the use of a window in the cast
- C. Simply record the findings in the nurse's notes only
- D. Outline the spot with a pencil and note the time and date on the cast
Correct Answer: D
Rationale: Outline the spot with a pencil and note the time and date on the cast. This is a good way to assess the amount of bleeding over a period of time. The bleeding does not appear to be excessive and some bleeding is expected with this type of surgery. The bleeding should also be documented in the nurse's notes.