Nokea
Which of the following actions could be considered a breach of patient confidentiality?
- A. Discussing patient information with other healthcare providers in a private setting.
- B. Sharing patient information with family members without the patient's consent.
- C. Discussing patient information in public areas where others may overhear.
- D. Sharing patient information in a private, secure setting with other healthcare providers involved in the patient's care.
Correct Answer: C
Rationale: Discussing patient information in public areas where others may overhear is considered a breach of patient confidentiality because it compromises the privacy and confidentiality of the patient's health information. Choices A and D are not breaches of confidentiality as discussing patient information with other healthcare providers in a private setting or in a private, secure setting with those involved in the patient's care is appropriate. Choice B is also incorrect as sharing patient information with family members without the patient's consent could potentially be a breach of privacy but is not the best answer in this context.
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The nurse is teaching a client with newly diagnosed hyperthyroidism about the management of the condition. Which of the following statements by the client indicates a need for further teaching?
- A. I should take my medication every day as prescribed.
- B. I need to avoid foods high in iodine.
- C. I can skip my medication on days when I feel fine.
- D. I should monitor my pulse regularly.
Correct Answer: C
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
Capillary glucose monitoring is being performed every 4 hours for a female client diagnosed with diabetic ketoacidosis. Insulin is administered using a scale of regular insulin according to glucose results. At 2 p.m., the client has a capillary glucose level of 250 mg/dl for which she receives 8 U of regular insulin. Nurse Vince should expect the dose's:
- A. Onset to be at 2 p.m. and its peak to be at 3 p.m.
- B. Onset to be at 2:15 p.m. and its peak to be at 3 p.m.
- C. Onset to be at 2:30 p.m. and its peak to be at 4 p.m.
- D. Onset to be at 4 p.m. and its peak to be at 6 p.m.
Correct Answer: C
Rationale: The correct answer is C. Regular insulin typically has an onset of action within 30 minutes and peaks 2-4 hours after administration. Given that the insulin was administered at 2 p.m., the onset of action can be expected around 2:30 p.m., and the peak effect would occur between 4-6 p.m. Choice A is incorrect as the onset and peak are too close together for regular insulin. Choice B is incorrect because the onset time is too soon after administration. Choice D is incorrect as the onset time is too delayed for regular insulin.
A 67-year-old male client has been complaining of sleeping more, increased urination, anorexia, weakness, irritability, depression, and bone pain that interferes with his ability to go outdoors. Based on these assessment findings, Nurse Richard would suspect which of the following disorders?
- A. Diabetes mellitus
- B. Diabetes insipidus
- C. Hypoparathyroidism
- D. Hyperparathyroidism
Correct Answer: D
Rationale: The symptoms described in the scenario, such as bone pain, increased urination, anorexia, and weakness, are indicative of hyperparathyroidism. In hyperparathyroidism, there is an excess of parathyroid hormone leading to increased calcium levels, which can result in bone pain and various systemic effects. Choices A, B, and C are incorrect because they do not align with the symptoms presented by the client. Diabetes mellitus primarily presents with polyuria, polydipsia, and hyperglycemia. Diabetes insipidus manifests as polyuria and polydipsia with dilute urine. Hypoparathyroidism usually presents with hypocalcemia, causing symptoms like muscle cramps, tingling sensations, and seizures.
Early this morning, a female client had a subtotal thyroidectomy. During evening rounds, Nurse Tina assesses the client, who now has nausea, a temperature of 105°F (40.5°C), tachycardia, and extreme restlessness. What is the most likely cause of these signs?
- A. Diabetic ketoacidosis
- B. Thyroid crisis
- C. Hypoglycemia
- D. Tetany
Correct Answer: B
Rationale: The correct answer is B: Thyroid crisis. Thyroid crisis, also known as thyroid storm, is a life-threatening condition that can occur after a thyroidectomy. Symptoms include high fever, tachycardia, extreme restlessness, and other signs of severe hyperthyroidism. Diabetic ketoacidosis (choice A) is a complication of diabetes characterized by hyperglycemia, ketosis, and acidosis, not typically seen post-thyroidectomy. Hypoglycemia (choice C) is low blood sugar levels and would not present with the symptoms described. Tetany (choice D) is a condition of involuntary muscle spasms due to low calcium levels and is not directly related to the symptoms observed in this scenario.
The client with type 2 DM is receiving dietary instructions from the nurse regarding the prescribed diabetic diet. The nurse determines that the client understands the instructions if the client states that:
- A. I need to skip meals if my blood glucose level is elevated.
- B. I need to eat a small meal or snack every 2 to 3 hours.
- C. I need to avoid using concentrated sweets in my diet.
- D. I need to eat a high-protein, low-carbohydrate diet.
Correct Answer: C
Rationale: The correct answer is C: 'I need to avoid using concentrated sweets in my diet.' Clients with type 2 diabetes should avoid concentrated sweets as they can cause rapid spikes in blood glucose levels, which can be detrimental to their health. Option A is incorrect because skipping meals can lead to fluctuations in blood glucose levels. Option B is incorrect as it does not address the specific issue of avoiding concentrated sweets. Option D is incorrect because a high-protein, low-carbohydrate diet is not typically recommended as the primary approach for managing type 2 diabetes.