Nokea
What must the nurse do when preparing a client for a computed tomography (CT) scan?
- A. Administer a laxative prep
- B. Encourage fluids
- C. Explain the procedure
- D. Administer a radioisotope
Correct Answer: C
Rationale: Explaining the procedure reduces anxiety and ensures cooperation. A CT scan may involve iodine dye, so checking for allergies (e.g., shellfish) is also important, but explanation is primary.
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The nurse reviews the HCP's orders for the newly admitted client diagnosed with DKA. Which order should the nurse question?
- A. Administer D5W intravenously (IV) at 125 mL per hour
- B. Administer KCL 10 mEq in 100 mL NaCl IV now
- C. Give sodium bicarbonate IV per pharmacy dosing if arterial pH is less than 7.0
- D. Start regular insulin infusion per protocol; titrate based on hourly glucose level
Correct Answer: A
Rationale: In DKA, the blood glucose level is above 300 mg/dL. Additional glucose will increase the glucose level further. Initially 0.45% or 0.9% sodium chloride (NaCl) is administered for fluid resuscitation.
If a regular diet is ordered, which between-meal snack should the nurse offer to help regulate the client's blood glucose level?
- A. A small carton of milk
- B. A small apple
- C. A handful of raisins
- D. A slice of bread
Correct Answer: A
Rationale: A small carton of milk provides a balance of carbohydrates and protein to stabilize blood glucose in hypoglycemia.
The client is admitted to rule out Cushing's syndrome. Which laboratory tests should the nurse anticipate being ordered?
- A. Plasma drug levels of quinidine, digoxin, and hydralazine.
- B. Plasma levels of ACTH and cortisol.
- C. A 24-hour urine for metanephrine and catecholamine.
- D. Spot urine for creatinine and white blood cells (WBCs).
Correct Answer: B
Rationale: ACTH and cortisol levels diagnose Cushing’s by confirming hypercortisolism. Other tests assess unrelated conditions (e.g., pheochromocytoma, renal function).
How does the nurse expect the urine that is collected for a routine urinalysis to appear?
- A. Tea-colored
- B. Pale yellow
- C. Goldless
- D. Light pink
Correct Answer: B
Rationale: In diabetes insipidus, the urine is typically dilute and pale yellow due to the large volume of water excreted.
Which instruction should the nurse give the client about insulin administration during periods of illness?
- A. Monitor blood glucose levels every 2 to 4 hours.
- B. Eat candy or sugar frequently.
- C. Attempt to drink a high-calorie beverage every hour.
- D. Test urine daily for protein.
Correct Answer: A
Rationale: Frequent blood glucose monitoring during illness helps adjust insulin doses to prevent complications.