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Which client would the nurse identify as being at risk for developing diabetes?
- A. The client who eats mostly candy and potatoes.
- B. The 22-year-old client who has been taking birth control pills.
- C. The client who has a cousin who has had diabetes for two (2) years.
- D. The 38-year-old female who delivered a 10-pound infant.
Correct Answer: D
Rationale: Delivering a large infant (macrosomia) indicates gestational diabetes history, a strong risk factor for type 2 diabetes. Candy/potatoes, birth control, and family history are less specific.
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The nurse is caring for the client who is experiencing symptoms associated with pheochromocytoma. Which intervention should be included in the plan of care for this client?
- A. Offer distractions such as television or music.
- B. Encourage family and friends to visit often.
- C. Assist with ambulation at least three times a day.
- D. Administer nicardipine for hypertension.
Correct Answer: D
Rationale: Nicardipine controls hypertension caused by excess catecholamines in pheochromocytoma.
The nurse is completing discharge teaching to the client diagnosed with acute pancreatitis. Which instruction should the nurse discuss with the client?
- A. Instruct the client to decrease alcohol intake.
- B. Explain the need to avoid all stress.
- C. Discuss the importance of stopping smoking.
- D. Teach the correct way to take pancreatic enzymes.
Correct Answer: A
Rationale: Decreasing alcohol intake is critical, as alcohol is a major cause of pancreatitis. Stress avoidance is unrealistic, smoking is secondary, and enzymes are for chronic cases.
The client diagnosed with acute pancreatitis has a ruptured pseudocyst. Which procedure should the nurse anticipate the HCP prescribing?
- A. Paracentesis.
- B. Chest tube insertion.
- C. Lumbar puncture.
- D. Biopsy of the pancreas.
Correct Answer: A
Rationale: A ruptured pancreatic pseudocyst can cause peritoneal irritation or fluid accumulation, potentially requiring drainage. Paracentesis removes abdominal fluid, which may be performed in severe cases, though surgical drainage or endoscopic intervention is more specific. Chest tube insertion is for pleural issues, lumbar puncture is for cerebrospinal fluid, and pancreatic biopsy is diagnostic, not therapeutic for a ruptured pseudocyst.
A client who has just had a thyroidectomy returns to the unit in stable condition. What equipment is it essential for the nurse to have readily available?
- A. Tracheostomy set
- B. Thoracotomy tray
- C. Dressing set
- D. Ice collar
Correct Answer: A
Rationale: A tracheostomy set is essential post-thyroidectomy due to the risk of airway obstruction from swelling or hematoma.
Twelve hours after a transsphenoidal hypophysectomy, the client keeps clearing his throat and complains of a drip in his mouth. To accurately assess this, the nurse should test the fluid for:
- A. sugar.
- B. protein.
- C. bacteria.
- D. blood.
Correct Answer: A
Rationale: A post-nasal drip post-transsphenoidal hypophysectomy may indicate cerebrospinal fluid (CSF) leakage, which contains glucose (sugar), unlike saliva or mucus.