Which of the following methods of insulin administration would be used in the initial treatment of hyperglycemia in a client with diabetic ketoacidosis?
- A. Subcutaneous
- B. Intramuscular
- C. IV bolus only
- D. IV bolus, followed by continuous infusion
Correct Answer: D
Rationale: The correct answer is D: IV bolus, followed by continuous infusion. In the initial treatment of hyperglycemia in a client with diabetic ketoacidosis, insulin is administered via IV bolus to quickly reduce blood glucose levels, followed by a continuous infusion to maintain control. Subcutaneous and intramuscular routes are not used in this situation as they are not rapid or predictable enough to address the acute hyperglycemia seen in diabetic ketoacidosis. IV bolus alone without the continuous infusion may not provide sustained control of blood glucose levels, making choice C incorrect.
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In developing a disaster management plan for a hospital, which resource should be the highest priority to have available in response to a bioterrorism event?
- A. A mental health specialist on the response team
- B. A sufficient supply of PPE
- C. A system for tracking client information
- D. A network for communication between staff members and families
Correct Answer: B
Rationale: During a bioterrorism event, the highest priority resource to have available is a sufficient supply of personal protective equipment (PPE). PPE is crucial in protecting healthcare workers and other responders from exposure to biological agents. While mental health support, client information tracking systems, and communication networks are important components of disaster management, in the context of a bioterrorism event, ensuring the safety of staff through adequate PPE takes precedence over other resources.
Your pediatric patient weighs 15.8 kg. How many pounds does this child weigh?
- A. 36 pounds
- B. 33.6 pounds
- C. 35 pounds
- D. 34.8 pounds
Correct Answer: D
Rationale: To convert 15.8 kg to pounds, you multiply by the conversion factor of 2.20462. So, 15.8 kg * 2.20462 = 34.8 pounds. Therefore, the child weighs 34.8 pounds. Choice A is incorrect as it is higher than the correct answer. Choice B is incorrect as it is lower than the correct answer. Choice C is incorrect as it rounds down the conversion result, leading to an inaccurate weight measurement.
Clients with type 1 diabetes may require which of the following changes to their daily routine during periods of infection?
- A. No change
- B. Less insulin
- C. More insulin
- D. Oral antidiabetic agents
Correct Answer: C
Rationale: During periods of infection, clients with type 1 diabetes may require more insulin to manage the increased blood glucose levels caused by stress and illness. Insulin needs often rise during infections due to the body's increased resistance to the effects of insulin. Therefore, increasing insulin doses is crucial to maintain blood glucose control. Choices A, B, and D are incorrect. Option A ('No change') is inaccurate because during infections, insulin requirements typically increase. Option B ('Less insulin') is incorrect as the body's increased insulin resistance during infections usually necessitates higher insulin doses. Option D ('Oral antidiabetic agents') is not suitable for type 1 diabetes management as these medications are primarily used for type 2 diabetes.
A nurse enters the hallway and discovers a visitor looking at a client's medical information on a computer. Which of the following actions should the nurse take first?
- A. Inform the care nurse that a visitor viewed a client's protected health information.
- B. Close the documentation program on the computer.
- C. Inform the visitor that the client's records are confidential.
- D. Find out which staff member left the documentation program on the screen.
Correct Answer: B
Rationale: The correct first action for the nurse to take is to close the documentation program on the computer to prevent further unauthorized access to the client's medical information. Choice A is incorrect because the immediate concern is to secure the information first. Choice C, while important, can be addressed after securing the information. Choice D, finding out which staff member left the program open, is not the immediate priority when patient confidentiality is at risk.
Which patient is at greatest risk for papilledema?
- A. An elderly patient with cataracts and macular degeneration
- B. A male patient with hypothyroidism
- C. A male patient with hyperthyroidism
- D. An adolescent with a closed head injury
Correct Answer: D
Rationale: An adolescent with a closed head injury is at the highest risk for papilledema due to increased intracranial pressure. Papilledema is often a consequence of elevated intracranial pressure, which can occur in conditions like head trauma. Choices A, B, and C do not directly correlate with an increased risk of papilledema compared to a closed head injury, which is more likely to lead to elevated intracranial pressure and subsequent papilledema.