Nokea
Which of the following IV solutions is hypertonic?
- A. Normal saline
- B. 0.45% NaCl
- C. 5% dextrose in 0.9% NaCl
- D. 0.225% NaCl
Correct Answer: C
Rationale: A hypertonic solution has a higher concentration of solutes compared to the intracellular fluid. In this case, 5% dextrose in 0.9% NaCl is hypertonic because it has a higher osmolarity due to the combined effect of dextrose and sodium chloride. The dextrose contributes to the hypertonicity, making the overall solution more concentrated than the intracellular fluid.
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Which of the ff is an important nursing intervention for HIV positive clients?
- A. Suggesting the use of herbal medications and alternative therapies
- B. Suggesting the use of psychostimulants such as methamphetamine
- C. Advising the client to avoid clinical drug trials
- D. Providing referral to support groups and resources for information
Correct Answer: D
Rationale: For HIV positive clients, one of the most important nursing interventions is to provide referral to support groups and resources where they can find emotional support, information, and guidance. Support groups can offer a sense of community, a safe space to share experiences, and practical advice on living with HIV. These groups can also provide valuable resources on managing HIV, accessing treatment, and coping with any associated stigma or discrimination. By connecting HIV positive clients to support groups and resources, nurses can help them navigate the challenges of living with HIV and promote their overall well-being and quality of life. This intervention fosters a holistic approach to care that goes beyond just medical treatment to address the social, emotional, and psychological needs of the client.
The nurse administered neutral protamine Hagedorn (NPH) insulin to a diabetic client at 7am. At what time would the nurse expect the client to be at most risk for a hypoglycemic reaction?
- A. 10:00 AM
- B. 4:00 PM
- C. Noon
- D. 10:00 PM
Correct Answer: D
Rationale: NPH insulin typically peaks in its action around 6-10 hours after administration. Therefore, after administering NPH insulin at 7am, the client would be at most risk for a hypoglycemic reaction around 10pm. This is when the insulin is exerting its strongest effect, potentially leading to lower blood sugar levels. Monitoring for hypoglycemia during this time frame is crucial to ensure prompt intervention if needed.
When creating a teaching program for the parents of Jessica who is diagnosed with pulmonic stenosis (PS), Nurse Alex would keep in mind that this disorder involves which of the following?
- A. A single vessel arising from both ventricles
- B. Obstruction of blood flow from the left ventricle
- C. Obstruction of blood flow from the right ventricle
- D. Return of blood to the heart without entry to the left atrium
Correct Answer: C
Rationale: Pulmonic stenosis (PS) is a heart condition where there is obstruction or narrowing of the pulmonary valve, which is responsible for allowing blood to flow out of the right ventricle to the lungs for oxygenation. This obstruction leads to decreased blood flow from the right side of the heart to the lungs, causing increased pressure in the right ventricle. This can result in symptoms such as fatigue, shortness of breath, and possible heart murmurs. It is essential for Nurse Alex to educate Jessica's parents about the impact of this obstruction in the right ventricle and the importance of monitoring Jessica's symptoms and seeking appropriate medical care when needed.
Which of the following types of hearing loss does the nurse understand is most improved with the use of a hearing aid?
- A. Conductive
- B. Mixed
- C. Sensorineural
- D. Central
Correct Answer: C
Rationale: Sensorineural hearing loss occurs when there is damage to the inner ear (cochlea) or the auditory nerve. This type of hearing loss is most commonly associated with aging or prolonged exposure to loud noises. Sensorineural hearing loss is typically permanent and cannot be medically or surgically corrected; however, it can be effectively managed with hearing aids. A hearing aid can amplify sound and help individuals with sensorineural hearing loss improve their ability to hear and communicate effectively. Conductive and mixed hearing losses may benefit from other interventions such as surgical procedures, while central hearing loss is related to the processing of sound in the brain and is not effectively managed by hearing aids.
The nurse is presenting an in-service session on assessing gestational age in newborns. Which information should be included?
- A. The newborn's length and weight are the most accurate indicators of gestational age.
- B. The newborn's Apgar score and the mother's estimated date of confinement (EDC) are combined to determine gestational age.
- C. The newborn's posture at rest and arm recoil are two physical signs used to determine gestational age.
- D. The newborn's chest circumference compared to the head circumference is the determinant for gestational age.
Correct Answer: C
Rationale: The newborn's posture at rest and arm recoil are two physical signs used to determine gestational age. Assessment of posture at rest involves observing the newborn's flexed or extended posture when lying flat on their back. Premature infants tend to have more flexed postures due to their immature muscular tone. Arm recoil refers to the ability of the newborn to return their extended arm flexes to the flexed position. This reflex is typically present in more mature infants. These physical signs, along with other factors such as skin texture, breast development, and ear formation, are used by healthcare providers to estimate the gestational age of newborns. While length, weight, and head circumference are also important measurements, the posture at rest and arm recoil are specifically used in determining gestational age.