Nokea
When teaching a client about insulin administration, the nurse should include which instruction?
- A. "Administer insulin after the first meal of the day."
- B. "Inject insulin at a 45-degree angle into the deltoid muscle."
- C. "Shake the insulin vial vigorously before withdrawing the medication."
- D. "Draw up clear insulin first when mixing two types of insulin in one syringe."
Correct Answer: D
Rationale: When mixing two types of insulin in one syringe, it is essential to draw up the clear insulin first before drawing up the cloudy insulin. This sequence prevents the clear insulin from becoming contaminated with the cloudy insulin and ensures accurate dosing. Drawing up the clear insulin first helps to minimize the risk of inaccurate dosing and maintains the effectiveness of the insulin being administered.
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An elderly patient, Mr. Cruz is being cared for by nurse Bennie because of pulmonary embolism. Nurse Bennie would anticipate an order for immediate administration of:
- A. warfarin
- B. heparin
- C. dexamethazone
- D. protamine sulfate
Correct Answer: B
Rationale: In the scenario of an elderly patient like Mr. Cruz with suspected pulmonary embolism, the nurse would anticipate an order for the immediate administration of heparin. Heparin is an anticoagulant medication that works quickly to prevent the further development of blood clots. It is often used as the initial treatment for pulmonary embolism to prevent existing blood clots from getting larger and reduce the risk of new clots forming. Heparin is preferred over warfarin initially because it has a more rapid onset of action. Warfarin, which is a commonly used anticoagulant for longer-term management, takes several days to reach its full effect and requires monitoring of the prothrombin time (INR). Therefore, in Mr. Cruz's acute situation, heparin would be the most appropriate choice for immediate intervention to address the pulmonary embolism.
Clients with myastherda gravis, Guillain - Barre Syndrome or amyothrophic sclerosis experience:
- A. Progressive deterioration until death
- B. Deficiencies of essential neurotransmitter
- C. Increased risk of respiratory complications
- D. Involuntary twitching of small muscle group
Correct Answer: C
Rationale: Clients with myasthenia gravis, Guillain-Barre Syndrome, or amyotrophic lateral sclerosis (ALS) are all affected by various neuromuscular conditions that can lead to respiratory complications. These conditions can cause weakness in the muscles involved in breathing, leading to difficulties with coughing, clearing secretions, and maintaining adequate ventilation. This weakness can ultimately result in an increased risk of breathing difficulties, respiratory infections, and respiratory failure. Therefore, clients with these conditions require close monitoring and respiratory support to manage and prevent complications related to respiratory function.
A client with cancer is scheduled for radiation therapy. The nurse knows that radiation at any treatment site may cause a certain adverse effect. Therefore, the nurse should prepare the client to expect:
- A. Hair loss.
- B. Fatigue.
- C. Stomatitis.
- D. Vomiting.
Correct Answer: A
Rationale: Radiation therapy works by targeting rapidly dividing cells in the body, which includes not only cancer cells but also healthy cells. Hair loss, also known as alopecia, is a common side effect of radiation therapy because the hair follicles are fast-growing cells that can be affected by the radiation. The extent of hair loss can vary depending on the dose and area of the body being treated. It is essential for nurses to prepare clients for the possibility of hair loss during radiation therapy and provide support and information on managing this side effect.
What discharge teaching is most important to help the patient who has had a splenectomy prevent infection?
- A. Avoid showering for 1 week.
- B. Sleep in a semi-fowler's position.
- C. Receive vaccines against infection.
- D. Stay on antibiotics for life.
Correct Answer: C
Rationale: Patients who have had a splenectomy are at increased risk for infections, particularly those caused by encapsulated bacteria such as Streptococcus pneumoniae. To prevent these infections, it is essential for these patients to receive vaccines against these bacteria. Vaccines recommended for patients who have had a splenectomy include the pneumococcal vaccine, meningococcal vaccine, and Hib vaccine. These vaccines help boost the body's immunity and provide protection against potentially life-threatening infections. It is important for healthcare providers to educate patients about the importance of receiving these vaccines to prevent infections post-splenectomy.
Which of the ff should the nurse include in the teaching plan of a client with acute bronchitis?
- A. Not coughing frequently
- B. Washing the hands frequently
- C. Consuming adequate calories
- D. Encouraging a semi-Fowler's position
Correct Answer: B
Rationale: In acute bronchitis, the highest priority in the teaching plan should focus on preventing the spread of infection. Washing hands frequently can help reduce the risk of spreading the infection to others or introducing new germs that could worsen the client's condition. Proper hand hygiene is one of the most important ways to prevent the transmission of respiratory infections, like bronchitis, by reducing the number of pathogens on the hands. This measure is important not only for the client's well-being but also for the health of those in close contact with the client.