Which of the following chronic complications is associated with diabetes?
- A. Dizziness, dyspnea on exertion, and coronary artery disease.
- B. Retinopathy, neuropathy, and coronary artery disease.
- C. Leg ulcers, cerebral ischemic events, and pulmonary infarcts.
- D. Fatigue, nausea, vomiting, muscle weakness, and cardiac arrhythmias.
Correct Answer: B
Rationale: The correct answer is B. Diabetes is associated with chronic complications such as retinopathy, neuropathy, and coronary artery disease. Choice A includes symptoms rather than chronic complications of diabetes. Choice C lists conditions not typically associated with diabetes. Choice D describes symptoms that may occur in various medical conditions but are not specific chronic complications of diabetes.
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Who should document care?
- A. The LPNs should document the care that they provided and the care that was given by unlicensed assistive staff.
- B. The registered nurse must document all of the care that is provided by the nursing assistants because they are accountable for all care.
- C. All staff members should document all of the care that they have provided.
- D. All staff should document all of the care that they have provided but the registered nurse, as the only independent practitioner, signs it.
Correct Answer: C
Rationale: All staff members should document the care they provided as part of their accountability and to ensure accurate and comprehensive records. In healthcare settings, it is essential for all staff to document the care they deliver for continuity of care and legal purposes. The registered nurse may sign off on the documentation for oversight purposes, but the responsibility of documenting care extends to all staff involved in patient care. Choices A and B incorrectly limit the responsibility to specific roles, while choice D inaccurately suggests that only the registered nurse signs off on the documentation, overlooking the importance of comprehensive documentation by all staff members involved.
A client with DM has an above-knee amputation because of severe peripheral vascular disease. Two days following surgery, when preparing the client for dinner, what is the nurse's primary responsibility?
- A. Check the client's serum glucose level
- B. Assist the client out of bed to the chair
- C. Place the client in a high-Fowler's position
- D. Ensure that the client's residual limb is elevated
Correct Answer: A
Rationale: The correct answer is to check the client's serum glucose level. In a client with diabetes who just had surgery, monitoring the serum glucose level is crucial to ensure proper management of the condition. This helps in preventing complications related to blood sugar fluctuations. Assisting the client out of bed may be important but not the primary responsibility at this time. Placing the client in a high-Fowler's position or ensuring the residual limb is elevated are important interventions for comfort and circulation but are not the primary concern in this scenario.
A charge nurse making rounds observes that an assistive personnel (AP) has applied wrist restraints to a client who is agitated and does not have a prescription for restraints. Which of the following actions should the nurse take first?
- A. Remove the restraints from the client's wrists
- B. Review the chart for nonrestraint alternatives for agitation
- C. Speak with the AP about the incident
- D. Inform the unit manager of the incident
Correct Answer: A
Rationale: The correct action for the nurse to take first is to remove the restraints from the client's wrists. Restraints should not be applied without a prescription due to the risk of harm to the client. Removing the restraints promptly is a priority to ensure the client's safety. Reviewing nonrestraint alternatives, speaking with the AP, and informing the unit manager can follow after ensuring the client's immediate safety by removing the restraints.
What is the role of a nurse in patient education?
- A. Providing patients with necessary information to manage their health
- B. Limiting information to prevent confusion
- C. Using complex medical terminology
- D. Discouraging questions from patients
Correct Answer: A
Rationale: The correct answer is A: Providing patients with necessary information to manage their health. Nurses play a crucial role in patient education by offering essential information to help patients understand and manage their health conditions. This empowers patients to make informed decisions about their health and improve their overall well-being. Choices B, C, and D are incorrect. Limiting information would hinder patient understanding and decision-making, using complex medical terminology can confuse patients, and discouraging questions goes against the essence of patient education.
Wilms' tumor is a form of:
- A. Renal cancer.
- B. Liver cancer.
- C. Basal cell carcinoma.
- D. Brain cancer.
Correct Answer: A
Rationale: Wilms' tumor is a type of kidney cancer that primarily affects children. The correct answer is A: Renal cancer. This tumor originates in the kidneys and is most commonly found in children, with the peak incidence around 3-4 years of age. Choice B, Liver cancer, is incorrect as Wilms' tumor specifically involves the kidneys, not the liver. Choice C, Basal cell carcinoma, is a form of skin cancer, not related to Wilms' tumor. Choice D, Brain cancer, is incorrect as Wilms' tumor is not associated with the brain but rather with the kidneys.