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What should the nurse include in the insulin administration instruction for the parents of a child being discharged on insulin?
- A. Insert the needle and aspirate before injecting
- B. Inject insulin into the extremity to be exercised to improve absorption
- C. The muscles in the abdomen and thigh are the easiest for self-administration
- D. Clean the injection site with soap and water and avoid alcohol
Correct Answer: C
Rationale: The correct answer is C because the muscles in the abdomen and thigh are the most suitable areas for self-administration of insulin due to consistent absorption. Choices A and B are incorrect as aspirating before injecting insulin is unnecessary, and injecting into an extremity to be exercised does not enhance absorption. Choice D is incorrect as alcohol should be used to clean the injection site instead of soap and water, which can cause skin irritation.
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When drawing blood from the diabetic patient for a glycosylated hemoglobin (HBA1c) test, the nurse explains to the woman that the test is used to determine:
- A. The highest glucose level in the past week.
- B. Her insulin levels.
- C. Glucose levels over the past three months.
- D. Her usual fasting glucose level.
Correct Answer: C
Rationale: The glycosylated hemoglobin (HBA1c) test reflects the average blood sugar levels over the past three months. It provides a more comprehensive view of the individual's glucose control compared to a single point-in-time measurement like a fasting glucose level or the highest glucose level in the past week. Choice A is incorrect because it focuses on a single high glucose level rather than the overall control over a period. Choice B is incorrect as HBA1c is not a test for insulin levels. Choice D is incorrect as the HBA1c test does not reflect a single fasting glucose level but rather an average over a more extended period.
How can the nurse best assess that the parents demonstrate understanding of the dressing change procedure prior to discharge for their child with burns?
- A. The parents explaining the importance of using sterile technique to the nurse.
- B. The nurse observing the parents changing the dressing using appropriate technique.
- C. The parents observing the nurse changing the dressing and confirming their understanding of the procedure.
- D. The nurse allowing the parents to explain the dressing change procedure and perform it in private to boost their confidence.
Correct Answer: B
Rationale: The most effective way for the nurse to assess the parents' understanding of the dressing change procedure is by observing them as they change the dressing using the correct technique. This direct observation ensures that the parents are able to perform the task correctly and confidently before discharge. Merely verbalizing or explaining the procedure may not accurately reflect the parents' competency in performing the actual task. Choice A involves the parents explaining to the nurse, which does not directly assess their practical skills. Choice C suggests the parents observing the nurse, which does not evaluate the parents' ability to perform the task independently. Choice D focuses on boosting the parents' confidence but does not directly assess their understanding and competency in performing the dressing change.
When working with a new adolescent patient, which greeting by the nurse indicates awareness of the needs of the adolescent client?
- A. I will talk with your parents first, and then you can tell me why you are here.
- B. Please let me know what your concerns are, and if you have any questions.
- C. Before we begin, I will need to know if you are sexually active.
- D. I will do the physical exam first, and then we will talk about your history.
Correct Answer: B
Rationale: The greeting 'Please let me know what your concerns are, and if you have any questions.' indicates awareness of the needs of the adolescent client. It encourages open communication, allows the adolescent to voice their concerns, and shows that their questions are welcomed and valued, fostering a trusting nurse-patient relationship. Choices A, C, and D do not prioritize the adolescent's perspective or promote open communication. Asking to talk to the parents first (Choice A) may hinder the adolescent's autonomy and trust. Inquiring about sexual activity (Choice C) may be necessary but should be approached with sensitivity and privacy. Doing the physical exam first (Choice D) before discussing the patient's history may not align with the adolescent's need for communication and understanding.
The Andrews family has been taking good care of their youngest, Archie, who was diagnosed with asthma. Which of the following statements indicate a need for further home care teaching?
- A. He should increase his fluid intake regularly to thin secretions.
- B. We'll make sure he avoids exercise to prevent attacks.
- C. He is to use his bronchodilator inhaler before the steroid inhaler.
- D. We need to identify what triggers his attacks.
Correct Answer: B
Rationale: The correct answer is B. Avoiding exercise entirely is not recommended for asthma management. Regular exercise can actually help strengthen the lungs and improve overall respiratory function. Teaching should focus on appropriate exercise routines that are suitable for individuals with asthma to prevent attacks. Choices A, C, and D are all appropriate and indicate good understanding of asthma management. Increasing fluid intake helps thin secretions, using the bronchodilator inhaler before the steroid inhaler follows the correct order of inhaler administration, and identifying triggers is essential for asthma control.
What is the most appropriate technique to use when explaining a central line dressing change to a preschool-age client?
- A. Show a picture of the procedure in a book.
- B. Explain the procedure with clear instructions.
- C. Let the child perform a dressing change on a doll.
- D. None of the above.
Correct Answer: C
Rationale: The most appropriate technique to use when explaining a central line dressing change to a preschool-age client is to let the child perform a dressing change on a doll. Preschool-age children learn best through play and hands-on activities. Allowing the child to practice on a doll helps them understand the procedure in a non-threatening and interactive way. This technique can reduce anxiety, increase cooperation, and enhance the child's understanding of the dressing change process. Choices A and B do not provide a hands-on approach, which is crucial for preschool-age children. Choice D is incorrect as providing an interactive experience is more effective than just showing pictures or giving verbal instructions.