Nokea
Which information is most important for the nurse to elicit from the client to effectively evaluate compliance with the prescribed therapy?
- A. The dosage and frequency of insulin administration
- B. The client's glucose monitoring records for the past week
- C. The client's weight and vital signs before the office interview
- D. The symptoms experienced in the past month
Correct Answer: B
Rationale: Glucose monitoring records provide direct evidence of blood glucose control and therapy compliance.
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Based on the knowledge that clients with Cushing's syndrome heal slowly, which nursing measure is most appropriate during the client's postoperative period?
- A. Monitoring infusion of I.V. antibiotics
- B. Removing tape toward the incision site
- C. Increasing the client's dietary protein intake
- D. Covering the wound with gauze
Correct Answer: C
Rationale: Increased dietary protein supports tissue repair and healing in Cushing's syndrome.
The client diagnosed with Addison's disease is admitted to the emergency department after a day at the lake. The client is lethargic, forgetful, and weak. Which intervention should the nurse implement?
- A. Start an IV with an 18-gauge needle and infuse NS rapidly.
- B. Have the client wait in the waiting room until a bed is available.
- C. Obtain a permit for the client to receive a blood transfusion.
- D. Collect urinalysis and blood samples for a CBC and calcium level.
Correct Answer: A
Rationale: Lethargy, confusion, and weakness suggest Addisonian crisis; rapid NS infusion corrects hypotension and dehydration. Waiting, transfusions, and labs are inappropriate first steps.
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.
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.
The male client diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH) secondary to cancer of the lung tells the nurse he wants to discontinue the fluid restriction and does not care if he dies. Which action by the nurse is an example of the ethical principle of autonomy?
- A. Discuss the information the client told the nurse with the health-care provider and significant other.
- B. Explain it is possible the client could have a seizure if he drank fluid beyond the restrictions.
- C. Notify the health-care provider of the client's wishes and give the client fluids as desired.
- D. Allow the client an extra drink of water and explain the nurse could get into trouble if the client tells the health-care provider.
Correct Answer: C
Rationale: Notifying the HCP and respecting the client’s fluid request honors autonomy. Sharing with others violates confidentiality, explaining risks is beneficence, and covertly giving water is unethical.