Which of the following best describes the role of insulin in the body?
- A. Insulin helps break down glucose into energy for the body
- B. Insulin facilitates the movement of glucose into cells
- C. Insulin converts excess glucose into fat for storage
- D. Insulin increases the breakdown of protein into amino acids
Correct Answer: B
Rationale: The correct answer is B: Insulin facilitates the movement of glucose into cells. Insulin is a hormone that helps regulate blood sugar levels by promoting the uptake of glucose from the bloodstream into cells, where it can be used for energy production. Choice A is incorrect because insulin doesn't break down glucose but rather helps cells take up glucose. Choice C is incorrect as insulin does not directly convert glucose into fat; excess glucose is stored as fat by other processes. Choice D is incorrect as insulin does not increase the breakdown of protein into amino acids; its primary role is in glucose metabolism.
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According to the principle of asepsis, which situation should the PN consider to be sterile?
- A. A one-inch border around the edges of a sterile field set up in the operating room
- B. A sterile glove that the PN thinks might have touched hair
- C. A wrapped, unopened sterile 4x4 gauze pad placed on a damp table top
- D. An open sterile Foley catheter kit set up on a table at the PN's waist level
Correct Answer: A
Rationale: According to the principle of asepsis, the one-inch border around the edges of a sterile field set up in the operating room is considered non-sterile, while the central area remains sterile. Therefore, the PN should consider the situation described in choice A to be sterile. Choice B is incorrect because a glove that may have touched hair is contaminated. Choice C is incorrect as a sterile item placed on a damp surface is considered contaminated. Choice D is incorrect as a sterile kit set up at the PN's waist level is prone to contamination.
After a hip replacement surgery, a client is instructed to use an abduction pillow while in bed. What is the primary purpose of this device?
- A. To reduce the risk of blood clots.
- B. To prevent hip dislocation.
- C. To improve circulation in the legs.
- D. To alleviate pain and discomfort.
Correct Answer: B
Rationale: The primary purpose of using an abduction pillow after hip replacement surgery is to prevent hip dislocation. The abduction pillow keeps the legs separated, which reduces the risk of hip dislocation by preventing excessive internal rotation and adduction of the hip joint. Choices A, C, and D are incorrect as the main goal of using the abduction pillow is to maintain proper positioning and stability of the hip joint to prevent dislocation, rather than addressing blood clots, circulation, or pain relief.
An older male client with Alzheimer's disease is admitted to an extended care facility. Which intervention should the PN include in the client's nursing care plan?
- A. Plan to have the same nursing staff provide care for the client whenever possible
- B. Describe the activities available to residents and encourage him to choose the ones he prefers
- C. Encourage the client to remain on the unit for three weeks until he is oriented to his new surroundings
- D. Introduce the client to the nursing staff and other residents as soon as possible
Correct Answer: A
Rationale: The correct intervention for a client with Alzheimer's disease in an extended care facility is to plan to have the same nursing staff provide care whenever possible. Consistency in caregivers helps reduce confusion and anxiety in clients with Alzheimer's disease, promoting a stable and supportive environment for the client. Choice B is incorrect as it focuses on activities rather than the consistency of caregivers. Choice C is incorrect as it suggests isolating the client, which can lead to increased confusion and distress. Choice D is incorrect as introducing the client to new people immediately can be overwhelming and may exacerbate their symptoms.
When documenting information in a client's medical record, what should the nurse do?
- A. Cross out errors with a single line and initial them
- B. Use a black ink pen
- C. Leave one line blank before each new entry
- D. End each entry with the nurse's signature and title
Correct Answer: D
Rationale: When documenting information in a client's medical record, the nurse should end each entry with their signature and title. This practice is crucial for legal and professional standards compliance as it ensures that the documentation is attributable to the responsible individual. Choices A, B, and C are incorrect because while crossing out errors, using a black ink pen, and leaving a blank line before each entry are good practices, they are not as critical as ensuring each entry is signed and titled by the nurse for accountability and traceability.
Inspiratory and expiratory stridor may be heard in a client who:
- A. Is experiencing an exacerbation of goiter
- B. Is experiencing an acute asthmatic attack
- C. Has aspirated a piece of meat
- D. Has severe laryngotracheitis
Correct Answer: D
Rationale: Inspiratory and expiratory stridor are high-pitched, wheezing sounds caused by disrupted airflow due to airway obstruction. Severe laryngotracheitis, involving inflammation and swelling of the larynx and trachea, leads to airway obstruction and can produce both inspiratory and expiratory stridor. Exacerbation of goiter, an acute asthmatic attack, and aspiration of a piece of meat are not typically associated with both inspiratory and expiratory stridor. Therefore, choices A, B, and C are incorrect.