Nokea
The statement about sleep which is NOT true is
- A. melatonin is secreted in dark-light cycle
- B. slow-wave sleep is needed for brain injury protection
- C. rapid eye movement (REM) sleep is responsible for dreams
- D. both REM and non-REM cycles are sufficient for sleep
Correct Answer: B
Rationale: Slow-wave sleep is primarily restorative, not protective against brain injury.
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A 45-year old female diabetic is displaying signs of irritability and irrational behavior during an office visit. The nurse observes visible tremors in the client's hands. based on the client's history and the nurse's understanding of diabetes mellitus, the nurse interprets these findings to be signs of:
- A. hyperglycemia
- B. hyperglycemic hyperosmolar
- C. diabetic ketoacidosis (DKA) nonketosis (HHNK)
- D. hypoglycemia
Correct Answer: D
Rationale: The signs of irritability, irrational behavior, and visible tremors in the hands observed in the 45-year old female diabetic suggest hypoglycemia. Hypoglycemia occurs when blood sugar levels drop below normal levels, causing the body and brain to receive inadequate fuel. This leads to symptoms like irritability, irrational behavior, and tremors, which are signs of the brain not receiving enough glucose for proper functioning. In diabetic patients, particularly those on medications like insulin or certain oral hypoglycemic agents, hypoglycemia can occur if they take too much medication, skip meals, or engage in excessive physical activity without adjusting their treatment regimen. Immediate treatment for hypoglycemia usually involves consuming a rapid source of sugar, such as glucose tablets, juice, or candy, to quickly raise blood sugar levels back to normal range.
Metabolic derangement secondary to tumor lysis syndrome in children includes all the following EXCEPT
- A. hyperuricemia
- B. hypernatremia
- C. hyperkalemia
- D. hyperphosphatemia
Correct Answer: B
Rationale: Hypernatremia is not typically associated with tumor lysis syndrome, whereas hyperuricemia, hyperkalemia, and hyperphosphatemia are common.
A child with type 1 diabetes mellitus is brought to the emergency department by the mother, who states that the child has been complaining of abdominal pain and has been lethargic. Diabetic ketoacidosis is diagnosed. Anticipating the plan of care, the nurse prepares to administer which type of intravenous (IV) infusion?
- A. Potassium infusion
- B. NPH insulin infusion
- C. 5% dextrose infusion
- D. Normal saline infusion
Correct Answer: D
Rationale: Diabetic ketoacidosis (DKA) is a potentially life-threatening complication of diabetes characterized by hyperglycemia, ketosis, and metabolic acidosis. The initial treatment for DKA requires correcting dehydration and electrolyte imbalances. Normal saline infusion is the preferred choice for initial fluid resuscitation in patients with DKA to address dehydration and restore intravascular volume. It helps improve organ perfusion and correct electrolyte imbalances such as hyponatremia and dehydration commonly seen in DKA patients. Administering normal saline helps replace lost fluids and improve circulation, which is crucial in the management of DKA. Potassium infusion may be needed later to replete potassium levels once the patient's kidney function has been assessed. NPH insulin infusion is not the initial treatment for DKA, although insulin therapy is an essential component of DKA management. 5% dextrose infusion is contraindicated in the initial treatment
A worried mother of a 4-year-old boy describing attacks of inconsolable crying episodes. The MOST appropriate action is
- A. reassures her that this is a normal phenomenon of temper tantrum
- B. seek more history regarding other skills and developmental domains
- C. refer her to pediatric psychiatry
- D. investigate social issues of the family
Correct Answer: A
Rationale: Temper tantrums are common at this age and often do not indicate pathology.
During the initial assessment, he is placed in a modified Trendelenburg position. What desired effect should the position have on the client?
- A. An increase in the client's blood pressure
- B. An increase in the client's respiratory rate f. An increase in the client's heart rate h. A decrease in blood loss
- C. An increase in the client's respiratory rate
- D. An increase in the client's heart rate h. A decrease in blood loss
Correct Answer: A
Rationale: Placing a client in a modified Trendelenburg position involves having the client lie flat on the back with the legs elevated above the level of the heart. The main purpose of this position is to help increase blood pressure in cases of hypotension or shock. By raising the legs above the heart level, gravity helps to facilitate the return of venous blood to the heart, which can increase cardiac output and, consequently, blood pressure. This position is commonly used in clinical settings to help improve perfusion to vital organs and assist in stabilizing a client's blood pressure.