Nokea
Which laboratory data indicate to the nurse the client’s pancreatitis is improving?
- A. The amylase and lipase serum levels are decreased.
- B. The white blood cell (WBC) count is decreased.
- C. The conjugated and unconjugated bilirubin levels are decreased.
- D. The blood urea nitrogen (BUN) serum level is decreased.
Correct Answer: A
Rationale: Acute pancreatitis is characterized by elevated serum amylase and lipase levels due to pancreatic inflammation. A decrease in these levels indicates reduced pancreatic injury and improvement in the condition. While a decreased WBC count may suggest resolving infection, it is less specific. Bilirubin levels are relevant for biliary obstruction, not pancreatitis improvement, and BUN reflects renal function, not pancreatic status.
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During change of shifts, a nurse discovers that a hospitalized client with diabetes received two doses of insulin. After notifying the physician, which nursing action is most appropriate?
- A. Completing an incident report
- B. Calling the intensive care unit (ICU)
- C. Performing frequent neurologic checks
- D. Monitoring the client's blood glucose level
Correct Answer: D
Rationale: Monitoring blood glucose is critical to detect and manage potential hypoglycemia from the double dose.
The nurse is caring for the client admitted in Addisonian crisis. Which medication, if prescribed, should the nurse plan to administer?
- A. Regular insulin
- B. Ketoconazole
- C. Sodium nitroprusside
- D. Hydrocortisone
Correct Answer: D
Rationale: Hydrocortisone is a corticosteroid used to replace deficient glucocorticoids in Addisonian crisis.
The client is diagnosed with acute pancreatitis. Which health-care provider's admitting order should the nurse question?
- A. Bedrest with bathroom privileges.
- B. Initiate IV therapy of D5W at 125 mL/hr.
- C. Weigh the client daily.
- D. Low-fat, low-carbohydrate diet.
Correct Answer: D
Rationale: A low-fat, low-carb diet is inappropriate during acute pancreatitis; clients are typically NPO to rest the pancreas. Bedrest, IV D5W, and weighing are appropriate.
The nurse is planning the care of a client diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH). Which interventions should be implemented? Select all that apply.
- A. Restrict fluids per health-care provider order.
- B. Assess level of consciousness every two (2) hours.
- C. Provide an atmosphere of stimulation.
- D. Monitor urine and serum osmolality.
- E. Weigh the client every three (3) days.
Correct Answer: A,B,D
Rationale: Fluid restriction, frequent consciousness checks, and osmolality monitoring manage SIADH’s hyponatremia and fluid overload. Stimulation is inappropriate, and weighing every 3 days is too infrequent.
The client ate 45 g of carbohydrate (carb) with the dinner meal. The client is to receive 2 units of aspart insulin subcutaneously for each carb choice (CHO) eaten (1 carb choice = 15 g). Which syringe shows the correct amount of insulin that the nurse should administer?
- A. Illustration 1: 16 units
- B. Illustration 2: 29 units
- C. Illustration 3: 1 unit
- D. Illustration 4: 6 units
Correct Answer: D
Rationale: The client should receive 6 units of insulin. Eating 45 g of carbohydrates equals 3 CHOs. If the client is to receive 2 units of insulin for each CHO, the total amount of aspart insulin is 3 CHO times 2 units per CHO = 6 units.