You are caring for a patient who has no cognitive functioning but only basic human functions such as opening the eyes and the sleep-wake cycle. What level of consciousness does this patient have?
- A. Obtunded
- B. A persistent vegetative state
- C. Locked-in syndrome
- D. Brain death
Correct Answer: B
Rationale: A persistent vegetative state is characterized by the absence of cognitive functioning while basic human functions like the sleep-wake cycle are retained. In this state, the patient shows reflex movements and basic responses to stimuli but lacks awareness or higher mental functions. Choices A, C, and D are incorrect because:
A) Obtunded refers to a decreased level of consciousness, not the absence of cognitive functioning.
C) Locked-in syndrome is a condition where the patient is aware and awake but cannot move or communicate due to complete paralysis of nearly all voluntary muscles except for vertical eye movements and blinking.
D) Brain death is the irreversible cessation of all brain activity, including the brainstem, leading to the loss of all functions of the brain.
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Dr. Shrunk orders intravenous (IV) insulin for Rita, a client with a blood sugar of 563. Nurse AJ administers insulin lispro (Humalog) intravenously (IV). What does the best evaluation of the nurse reveal? Select one that does not apply.
- A. The nurse could have given the insulin subcutaneously.
- B. The nurse did not have to contact the physician.
- C. The nurse should have used regular insulin (Humulin R).
- D. The nurse used the correct insulin.
Correct Answer: C
Rationale: The best evaluation of the nurse reveals that she should have used regular insulin (Humulin R) for IV administration. Regular insulin is the only insulin approved for intravenous administration due to its pharmacokinetic properties. Insulin lispro (Humalog) is not suitable for IV use. Choice A is incorrect because giving insulin intravenously is necessary in this case of high blood sugar. Choice B is incorrect because administering a different insulin without consulting the physician is not appropriate. Choice D is incorrect because the nurse used the incorrect insulin, which could pose risks to the client's health.
A nurse on a med-surg unit is caring for a group of clients with the assistance of an LPN and an AP. Which of the following tasks should the nurse assign to the LPN?
- A. Reinforce dietary teaching with a client who has heart disease.
- B. Obtaining a urine specimen from an older adult client
- C. Providing postmortem care for a client who has just died.
- D. Accompanying a client who just had a wound debridement to PT.
Correct Answer: A
Rationale: The correct answer is to reinforce dietary teaching with a client who has heart disease. This task falls within the LPN's scope of practice as they can provide education and support related to nutrition. Obtaining a urine specimen (Choice B) is typically performed by nursing assistants. Providing postmortem care (Choice C) is a sensitive task usually performed by registered nurses. Accompanying a client to physical therapy (Choice D) is often done by nursing assistants or other supportive staff.
A nurse reviews a client's laboratory report and notes that the client's serum phosphorus level is 2.0 mg/dL. Which condition most likely caused this serum phosphorus level?
- A. Alcoholism
- B. Renal insufficiency
- C. Hypoparathyroidism
- D. Tumor lysis syndrome
Correct Answer: A
Rationale: The correct answer is A: Alcoholism. Alcoholism can lead to hypophosphatemia due to poor dietary intake and other factors. Excessive alcohol consumption can result in malnutrition, particularly a deficiency in phosphorus. Choices B, C, and D are unlikely to cause low serum phosphorus levels. Renal insufficiency is more likely to cause hyperphosphatemia, hypoparathyroidism is associated with hypocalcemia rather than hypophosphatemia, and tumor lysis syndrome typically presents with hyperphosphatemia due to the release of intracellular phosphate.
A nurse is assisting with the orientation of a newly licensed nurse. The newly licensed nurse is having trouble focusing and has difficulty completing care for his assigned clients. Which of the following interventions is appropriate?
- A. Offer to provide care for his clients while he takes a break
- B. Advise him to complete less time-consuming tasks first
- C. Ask other staff members to take over some of his tasks
- D. Recommend that he take time to plan at the beginning of his shift
Correct Answer: D
Rationale: The correct intervention is to recommend that the new nurse takes time to plan at the beginning of his shift. Planning ahead can help improve time management and focus. Option A is not ideal as it does not address the root cause of the issue and may not promote independence. Option B may not be effective if the nurse is struggling with time management in general. Option C involves shifting responsibilities to others without addressing the new nurse's need for improvement in managing his workload, which should be the priority.
Which of the following new opportunities might a new nurse see in the future?
- A. Transitional care
- B. Traditional care
- C. Hospital-based care
- D. Care based on cost
Correct Answer: A
Rationale: In the future, new nurses may see opportunities in transitional care. Transitional care involves the coordination and continuity of healthcare during a movement from one healthcare setting to another. This type of care is increasingly important in today's healthcare landscape due to the focus on improving patient outcomes and reducing hospital readmissions. Choices B, C, and D are incorrect as they do not represent emerging opportunities for new nurses in the future. Traditional care and hospital-based care are existing models of care delivery, while care based solely on cost does not align with the holistic approach to patient care that is becoming more prevalent in healthcare.