Nokea
Which of the following conditions is the most significant risk factor for the development of type 2 diabetes mellitus?
- A. Cigarette smoking.
- B. High-cholesterol diet.
- C. Obesity.
- D. Hypertension.
Correct Answer: C
Rationale: Obesity is the most significant risk factor for developing type 2 diabetes mellitus due to its role in insulin resistance. Excess body fat, especially around the abdomen, leads to increased production of inflammatory markers and hormones that can cause insulin resistance. While cigarette smoking, high-cholesterol diet, and hypertension can contribute to health issues, they are not as directly linked to the development of type 2 diabetes mellitus as obesity.
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In a patient with deep vein thrombosis (DVT), which of the following symptoms would be expected?
- A. Chest pain.
- B. Shortness of breath.
- C. Coughing up blood.
- D. Cyanosis.
Correct Answer: B
Rationale: Shortness of breath is a common symptom of deep vein thrombosis (DVT) due to the risk of a pulmonary embolism. DVT occurs when a blood clot forms in a deep vein, usually in the legs. If a portion of the clot breaks loose and travels to the lungs, it can cause a pulmonary embolism, leading to symptoms like shortness of breath. Chest pain is more commonly associated with conditions like a heart attack or pulmonary embolism itself. Coughing up blood is a symptom more indicative of conditions such as pulmonary embolism or lung cancer. Cyanosis, which is a bluish discoloration of the skin or mucous membranes due to poor oxygenation, can be seen in severe cases of pulmonary embolism but is not a typical symptom of DVT.
During spring break, a young adult presents to the urgent care clinic and reports a stiff neck, a fever for the past 6 hours, and a headache. Which intervention is most important for the nurse to implement first?
- A. Initiate isolation precautions
- B. Administer an antipyretic
- C. Draw blood cultures
- D. Prepare for lumbar puncture
Correct Answer: A
Rationale: The correct answer is to initiate isolation precautions. This is the priority action because the patient presents with symptoms that could be indicative of meningitis, an infectious disease that requires isolation to prevent its spread. Administering an antipyretic (Choice B) may help manage the fever but does not address the need for isolation. Drawing blood cultures (Choice C) and preparing for a lumbar puncture (Choice D) are important steps in diagnosing meningitis but should come after initiating isolation precautions to prevent potential transmission of the infection to others.
A client is scheduled to have an arteriogram. During the arteriogram, the client reports having nausea, tingling, and dyspnea. The nurse's immediate action should be to:
- A. Administer epinephrine.
- B. Inform the physician.
- C. Administer oxygen.
- D. Inform the client that the procedure is almost over.
Correct Answer: B
Rationale: The correct immediate action for the nurse to take in this situation is to inform the physician. The symptoms described - nausea, tingling, and dyspnea - indicate a potential allergic reaction to the contrast dye used in the arteriogram. It is crucial to notify the physician promptly so that further assessment and appropriate interventions can be initiated. Administering epinephrine without physician guidance can be dangerous as the physician needs to evaluate the severity of the reaction and determine the necessary treatment. Administering oxygen may be needed but should be done under the physician's direction. Informing the client that the procedure is almost over is not a priority when the client is experiencing symptoms of a possible allergic reaction.
In a patient with diabetes mellitus, which of the following is a sign of hypoglycemia?
- A. Polydipsia.
- B. Polyuria.
- C. Sweating.
- D. Dry skin.
Correct Answer: C
Rationale: Sweating is a common sign of hypoglycemia in diabetic patients. When blood sugar levels drop too low, the body releases stress hormones like adrenaline, which can cause sweating as a response to the perceived danger. Polydipsia (excessive thirst) and polyuria (excessive urination) are actually more commonly associated with hyperglycemia, not hypoglycemia. Dry skin is not typically a sign of hypoglycemia.
In a patient with chronic kidney disease, which of the following is a common electrolyte imbalance?
- A. Hyperkalemia.
- B. Hypokalemia.
- C. Hypernatremia.
- D. Hyponatremia.
Correct Answer: A
Rationale: Hyperkalemia is a common electrolyte imbalance in chronic kidney disease. In chronic kidney disease, the kidneys' reduced function leads to the decreased excretion of potassium, resulting in elevated serum potassium levels. This can be dangerous as hyperkalemia can lead to life-threatening arrhythmias. Hypokalemia (Choice B) is less common in chronic kidney disease as the impaired kidneys tend to retain potassium. Hypernatremia (Choice C) is more commonly seen in conditions such as dehydration, not primarily in chronic kidney disease. Hyponatremia (Choice D) is also possible in chronic kidney disease but is less common compared to hyperkalemia.