Nokea
Which intervention is appropriate for a client on hemodialysis?
- A. Check fistula for a thrill.
- B. Restrict all fluids.
- C. Administer heparin post-dialysis.
- D. Encourage high-protein diet.
Correct Answer: A
Rationale: Checking for a thrill ensures fistula patency for dialysis.
You may also like to solve these questions
The nurse has attended a continuing education conference regarding medication administration and meal times. Which statement, if made by the nurse, would indicate correct understanding?
- A. Proton pump inhibitors (PPls) should be given as the client eats their breakfast.
- B. Glucocorticoids should be given on an empty stomach to prevent gastrointestinal irritation.
- C. Rapid-acting insulins should be administered approximately 5-10 minutes before meals
- D. Levodopa-Carbidopa should be administered with a high-protein snack to enhance its absorption.
Correct Answer: C
Rationale: Rapid-acting insulins are administered 5-10 minutes before meals to match glucose spikes.
The nurse is caring for an older adult in the emergency department with moderate hypothermia. Which of the following actions should the nurse take? Select all that apply.
- A. Apply external heat with a heating blanket to the client's trunk.
- B. Actively rewarm the extremities first, followed by the client's trunk.
- C. Use extracorporeal rewarming methods such as cardiopulmonary bypass or hemodialysis.
- D. Monitor for fluid, electrolyte, and metabolic abnormalities.
- E. Administer ordered medications at spaced longer intervals.
- F. Administer room temperature intravenous (IV) fluids for core rewarming.
Correct Answer: A,D,F
Rationale: Applying heat to the trunk (A), monitoring electrolytes (D), and using room-temperature IV fluids (F) are appropriate for moderate hypothermia. Rewarming extremities first (B) risks core afterdrop, extracorporeal methods (C) are for severe cases, and altering medication intervals (E) lacks evidence.
A client is to receive glargine (Lantus) insulin in addition to a dose of aspart (NovoLog). When the nurse checks the blood glucose level at the bedside, it is greater than 200 mg/dL. How should the nurse administer the insulins?
- A. Put air into the glargine insulin vial, and then air into the aspart insulin vial, and draw up the correct dose of aspart insulin first.
- B. Roll the glargine insulin vial, then roll the aspart insulin vial. Draw up the longer-acting glargine insulin first.
- C. Shake both vials of insulin before drawing up each dose in separate insulin syringes.
- D. Add a little air to the glargine insulin vial and draw up the correct dose in an insulin syringe; then, with a different insulin syringe, put air into the aspart vial and draw up the correct dose.
Correct Answer: D
Rationale: Glargine and aspart insulins cannot be mixed. They should be drawn up in separate syringes to maintain their distinct actions (long-acting vs. rapid-acting). Shaking or rolling is inappropriate for glargine, which is clear.
The nurse is caring for a client who is receiving prescribed ketorolac. Which of the following client findings would indicate a therapeutic response? Select all that apply.
- A. Decreased pain
- B. Increased urinary output
- C. Decreased blood pressure
- D. Decreased temperature
- E. Increased muscle coordination
Correct Answer: A,D
Rationale: Ketorolac, an NSAID, reduces pain and inflammation, which can lower temperature in febrile clients. It does not directly affect urinary output, blood pressure, or muscle coordination.
Bed rest is prescribed for a client with pneumonia during the acute phase of the illness. The nurse should determine the effectiveness of bed rest by assessing the client's:
- A. Decreased cellular demand for oxygen.
- B. Reduced episodes of coughing.
- C. Diminished pain when breathing deeply.
- D. Ability to expectorate secretions more easily.
Correct Answer: A
Rationale: Bed rest reduces oxygen demand by decreasing metabolic rate, aiding recovery in pneumonia. Reduced coughing, diminished pain, and easier expectoration are secondary benefits but not the primary measure of bed rest effectiveness.