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 type 2 diabetes due to its impact on insulin resistance.
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The nurse teaches the client with chronic cancer pain about optimal pain control. Which of the following recommendations is most effective for pain control?
- A. Get used to some pain and use a little less medication than needed to keep from being addicted.
- B. Take prescribed analgesics on an around-the-clock schedule to prevent recurrent pain.
- C. Take analgesics only when pain returns.
- D. Take enough analgesics around the clock so that you can sleep 12 to 16 hours a day to block the pain.
Correct Answer: B
Rationale: Taking analgesics around-the-clock prevents recurrent pain by maintaining steady drug levels, which is the most effective strategy for chronic cancer pain.
Prior to surgery, the nurse is instructing a client who will have a total hip replacement tomorrow. Which of the following information is most important to include in the teaching plan at this time?
- A. Teaching how to prevent hip flexion.
- B. Demonstrating coughing and deep-breathing techniques.
- C. Showing the client what an actual hip prosthesis looks like.
- D. Assessing the client's fears about the procedure.
Correct Answer: A
Rationale: Preventing hip flexion is critical to avoid dislocation post-surgery.
The client who does not respond adequately to fluid replacement has an order for an I.V. infusion of dopamine hydrochloride at 5 µg/kg/minute. To determine that the drug is having the desired effect, the nurse should assess the client for:
- A. Increased renal and mesenteric blood flow.
- B. Increased cardiac output.
- C. Vasoconstriction.
- D. Reduced preload and afterload.
Correct Answer: B
Rationale: Dopamine at 5 µg/kg/minute primarily increases cardiac output by enhancing myocardial contractility and heart rate, improving perfusion in shock. Renal/mesenteric flow occurs at lower doses, vasoconstriction at higher doses, and preload/afterload reduction is not a primary effect.
The nurse is caring for a client who sustained injuries from a light bulb explosion. On assessment, the nurse notes that a piece of glass was lodged in the client's eye. The initial nursing intervention should be which of the following?
- A. Attempt to carefully remove the glass from the eye
- B. Reassure the client that everything is okay
- C. Administer a sedative for pain relief
- D. Advise the client to remain in a sitting position until a specialist arrives
Correct Answer: D
Rationale: A foreign object like glass in the eye requires specialist intervention. Keeping the client in a sitting position minimizes further damage until a specialist evaluates. Attempting removal, false reassurance, or sedation without specialist input is inappropriate.
A client develops lymphedema after a left mastectomy with lymph node dissection. Which of the following should be included in the discharge teaching plan? Select all that apply.
- A. Do not allow blood pressures or blood draws in the affected arm.
- B. Avoid application of sunscreen on the left arm.
- C. Use an electric razor for shaving.
- D. Immobilize the left arm.
- E. Elevate the left arm.
- F. Perform hand pump exercises.
Correct Answer: A,C,E,F
Rationale: Preventing trauma (A, C), elevating the arm (E), and performing exercises (F) reduce lymphedema risk and promote lymphatic drainage. Sunscreen (B) is safe, and immobilization (D) is not recommended.