Nokea
Which of the following ethnic groups has the highest risk of developing diabetes mellitus type 2 and should be routinely screened for diabetes?
- A. Hispanics
- B. Asians
- C. Caucasians
- D. African-Americans
Correct Answer: A
Rationale: Hispanics (A) have the highest risk for type 2 diabetes due to genetic and socioeconomic factors, requiring routine screening.
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A removal of the left lower lobe of the lung is performed on a client with lung cancer. Which post-operative measure would usually be included in the plan?
- A. Closed chest drainage
- B. A tracheostomy
- C. A Swan Ganz Monitor
- D. Percussion vibration and drainage
Correct Answer: A
Rationale: Closed chest drainage is used post-lobectomy to remove air and fluid from the pleural space, promoting lung re-expansion.
When assessing the urinary output of a client who has had extracorporeal lithotripsy, the nurse can expect to find:
- A. Cherry-red urine that gradually becomes clearer
- B. Orange-tinged urine containing particles of calculi
- C. Dark red urine that becomes cloudy in appearance
- D. Dark, smoky-colored urine with high specific gravity
Correct Answer: A
Rationale: Extracorporeal lithotripsy breaks up kidney stones, leading to cherry-red urine from minor bleeding that clears as healing progresses.
The nurse has just administered morphine 4 mg IV to a client with severe pain from a kidney stone. The client then asks to get up to the toilet. Which is the correct nursing action for this client?
- A. assist the client to the toilet
- B. offer the client a bedpan or urinal
- C. obtain an order for a Foley catheter
- D. place a bedside commode in the room
Correct Answer: B
Rationale: Morphine can cause sedation and dizziness, increasing fall risk. Offering a bedpan or urinal is safer than ambulating to the toilet.
The nurse is caring for a client with bipolar disorder. The client has been manipulating some of the staff and other clients in order to get her way. Which actions by the nurse are appropriate in managing this client? Select all that apply.
- A. giving support when the client exhibits positive behaviors
- B. setting clear limits and communicating expected behaviors
- C. role playing with the client to demonstrate appropriate behaviors
- D. treating the client more like a friend in order to show respect for her as a person
- E. giving the client small gifts, such as extra dessert, in order to encourage appropriate behavior
Correct Answer: A,B,C
Rationale: Appropriate actions include reinforcing positive behaviors (A), setting clear limits (B), and role-playing (C) to promote appropriate interactions. Treating as a friend (D) or giving gifts (E) blurs boundaries and encourages manipulation.
A nurse is giving instructions to parents of a child who had a tonsillectomy. Which instruction is the most important?
- A. drink orange juice to relieve discomfort
- B. drink extra milk to relieve discomfort
- C. avoid drinking from a straw
- D. rinse twice a day with antiseptic mouthwash
Correct Answer: C
Rationale: Avoiding straws prevents suction that could dislodge clots and cause bleeding, a critical post-tonsillectomy precaution.