Nokea
What is the most common cause of HHNS?
- A. Insulin overdose
- B. Removal of the adrenal gland
- C. Undiagnosed, untreated hyperpituitarism
- D. Undiagnosed, untreated diabetes mellitus
Correct Answer: D
Rationale: The correct answer is D: Undiagnosed, untreated diabetes mellitus. Hyperosmolar hyperglycemic nonketotic syndrome (HHNS) is most commonly caused by undiagnosed and untreated diabetes mellitus. Insulin overdose (Choice A) is not a typical cause of HHNS; it is more related to hypoglycemia. Removal of the adrenal gland (Choice B) can lead to adrenal insufficiency but is not a common cause of HHNS. Undiagnosed, untreated hyperpituitarism (Choice C) is not a usual cause of HHNS; it is more related to pituitary hormone imbalances rather than hyperglycemia.
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What does the mnemonic PERLA stand for in the assessment of the eyes?
- A. Pupils equally reactive to light and accommodation
- B. Patient eyes are equally recessed and responsive to light and acuity
- C. Patient eyes are equally responsive to light and acuity
- D. Pupils equally reactive to light and acuity
Correct Answer: A
Rationale: The correct answer is A: 'Pupils equally reactive to light and accommodation.' PERLA is a mnemonic used in eye assessments to check for Pupils being equally reactive to Light and Accommodation. Choice B is incorrect as it includes irrelevant information about the eyes being recessed. Choice C is incorrect as it is missing the mention of pupils and accommodation. Choice D is incorrect as it misses the mention of accommodation.
A nurse on a med-surg unit is caring for a group of clients with the assistance of an LPN and an AP. Which of the following tasks should the nurse assign to the LPN?
- A. Reinforce dietary teaching with a client who has heart disease.
- B. Obtaining a urine specimen from an older adult client
- C. Providing postmortem care for a client who has just died.
- D. Accompanying a client who just had a wound debridement to PT.
Correct Answer: A
Rationale: The correct answer is to reinforce dietary teaching with a client who has heart disease. This task falls within the LPN's scope of practice as they can provide education and support related to nutrition. Obtaining a urine specimen (Choice B) is typically performed by nursing assistants. Providing postmortem care (Choice C) is a sensitive task usually performed by registered nurses. Accompanying a client to physical therapy (Choice D) is often done by nursing assistants or other supportive staff.
Dr. Shrunk orders intravenous (IV) insulin for Rita, a client with a blood sugar of 563. Nurse AJ administers insulin lispro (Humalog) intravenously (IV). What does the best evaluation of the nurse reveal? Select one that does not apply.
- A. The nurse could have given the insulin subcutaneously.
- B. The nurse did not have to contact the physician.
- C. The nurse should have used regular insulin (Humulin R).
- D. The nurse used the correct insulin.
Correct Answer: C
Rationale: The best evaluation of the nurse reveals that she should have used regular insulin (Humulin R) for IV administration. Regular insulin is the only insulin approved for intravenous administration due to its pharmacokinetic properties. Insulin lispro (Humalog) is not suitable for IV use. Choice A is incorrect because giving insulin intravenously is necessary in this case of high blood sugar. Choice B is incorrect because administering a different insulin without consulting the physician is not appropriate. Choice D is incorrect because the nurse used the incorrect insulin, which could pose risks to the client's health.
When developing an educational program for staff regarding a new intravenous pump, what is the correct sequence of actions for a nurse to take?
- A. Develop learning objectives for the program
- B. Identify what skills to teach the staff members
- C. Conduct program evaluation with staff members
- D. Schedule several sessions of the program
Correct Answer: B
Rationale: The correct sequence of actions when developing an educational program for staff regarding a new intravenous pump is to first identify what skills to teach the staff members. This step is essential as it sets the foundation for the learning objectives to be developed next. Once the learning objectives are established, scheduling several sessions of the program can be planned accordingly. Finally, after the program has been conducted, program evaluation with staff members should take place to assess the effectiveness of the educational program. Therefore, options A, C, and D are out of sequence, making them incorrect choices.
A hospice nurse is caring for a client who has a terminal illness and reports severe pain. After the nurse administers the prescribed opioid and benzodiazepine, the client becomes somnolent and difficult to arouse. Which of the following actions should the nurse take?
- A. Withhold the benzodiazepine but continue the opioid
- B. Contact the provider about replacing the opioid with an NSAID
- C. Administer the benzodiazepine but withhold the opioid
- D. Continue the medication dosages that relieve the client's pain
Correct Answer: B
Rationale: The correct action for the nurse to take is to contact the provider about replacing the opioid with an NSAID. In this scenario, the client is experiencing excessive sedation after the administration of both opioid and benzodiazepine. Switching to a non-opioid analgesic like an NSAID can help manage pain effectively without causing additional sedation. Option A is incorrect because continuing the opioid may exacerbate sedation. Option C is incorrect as administering the benzodiazepine may further increase sedation. Option D is incorrect because maintaining the current medication dosages that are causing excessive sedation is not in the client's best interest.