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A patient with Alzheimer's disease is admitted with suspected dehydration after his daughter reports that he's refused to drink anything for the past 3 days.
Which lab result is most expected with dehydration?
- A. Urine specific gravity of 1.005.
- B. Serum sodium level of 150 mEq/L.
- C. Hematocrit of 38%
- D. Elevated WBC
Correct Answer: B
Rationale: Hypernatremia (elevated sodium) is expected in dehydration due to water loss.
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The nurse should explain to a client that tolbutamide (Orinase) is effective for diabetics who
- A. can no longer produce any insulin.
- B. produce minimal amounts of insulin.
- C. are unable to administer their injections.
- D. have a sustained decreased blood glucose.
Correct Answer: B
Rationale: Tolbutamide, an oral hypoglycemic, is effective for type 2 diabetes patients who produce minimal insulin, stimulating insulin release. Type 1 diabetics (A) produce no insulin, injection inability (C) is irrelevant, and low blood glucose (D) is not an indication for tolbutamide.
What finding signifies that children have attained the stage of concrete operations (Piaget)?
- A. Explores the environment with the use of sight and movement
- B. Thinks in mental images or word pictures
- C. Makes the moral judgment that 'stealing is wrong'
- D. Reasons that homework is time-consuming yet necessary
Correct Answer: C
Rationale: The stage of concrete operations is depicted by logical thinking and moral judgments.
The nurse is administering terbutaline (Brethine) to a client in labor. Prior to administration of the medication, the nurse assesses the client's pulse to be 144. The nurse's priority action should be to
- A. withhold the medication.
- B. decrease the dose by half.
- C. administer the medication.
- D. wait 15 minutes, then recheck the rate.
Correct Answer: A
Rationale: Terbutaline, a tocolytic, can cause maternal tachycardia. A pulse of 144 indicates significant tachycardia, a side effect requiring the medication to be withheld to prevent further cardiovascular strain. Decreasing the dose (B) is not within nursing scope, administering (C) ignores the risk, and waiting (D) delays intervention.
Thrombus formation is a danger for all post operative patients. The nurse should act independently to prevent this complication by:
The nurse should act independently to prevent this complication by:
- A. Applying elastic stockings.
- B. Massaging gently with lotion.
- C. Encouraging in-bed exercises.
- D. Providing adequate fluids intake.
Correct Answer: C
Rationale: In-bed exercises promote venous return, reducing the risk of thrombus formation.
Signs of impaired breathing in infants and children include all of the following except:
- A. nasal flaring.
- B. grunting.
- C. seesaw breathing.
- D. quivering lips.
Correct Answer: D
Rationale: Nasal flaring, grunting, and seesaw breathing are signs of respiratory distress in infants and children. Quivering lips are not a recognized indicator of impaired breathing. Physiological Adaptation