You are teaching your clients the difference between Type I (IDDM) and Type II (NDDM) diabetes. Which of the following statements is true?
- A. Both types of diabetes mellitus clients are prone to developing ketosis.
- B. Type II (NIDDM) is more common and preventable compared to Type I (IDDM) diabetes, which is genetic.
- C. Type I (IIDM) is characterized by fasting hyperglycemia.
- D. Type II (NIDDM) is characterized by abnormal immune response.
Correct Answer: D
Rationale: The correct answer is D. Type II diabetes (NIDDM) is characterized by insulin resistance and a relative lack of insulin. It is not primarily characterized by an abnormal immune response. Option A is incorrect because only Type I diabetes clients are prone to developing ketosis due to a lack of insulin. Option B is incorrect because while Type II diabetes is more common and often preventable through lifestyle changes, it is not solely genetic. Option C is incorrect because Type I diabetes, not Type II, is characterized by fasting hyperglycemia due to an absolute lack of insulin production.
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The nurse cares for a hospitalized adolescent with the diagnosis of anorexia nervosa. Which nursing goal is a priority for this client?
- A. Encourage effective coping skills
- B. Restore normal eating habits
- C. Stop weight loss or restore weight
- D. Promote realistic self-image
Correct Answer: C
Rationale: In the treatment of anorexia nervosa, stopping weight loss or restoring weight is a critical priority. This helps address the immediate health risks associated with severe malnutrition and supports the client's physical well-being. Encouraging effective coping skills, restoring normal eating habits, and promoting a realistic self-image are essential aspects of treatment but may come later in the care plan once the immediate risk of severe weight loss has been addressed.
After cleaning the abrasions and applying antiseptic, the nurse applies a cold compress to the swollen ankle as ordered by the physician. This statement shows that the nurse has a correct understanding of the use of a cold compress:
- A. Cold compress reduces blood viscosity in the affected area
- B. It is safer to apply than a hot compress
- C. Cold compress prevents edema and reduces pain
- D. It eliminates toxic waste products due to vasodilation
Correct Answer: C
Rationale: The correct understanding of using a cold compress includes knowing that it helps prevent edema and reduces pain. Cold application constricts blood vessels, reducing blood flow to the area, which helps decrease swelling and pain. Choices A, B, and D are incorrect because cold compresses do not directly affect blood viscosity, safety compared to hot compresses, or eliminate toxic waste products due to vasodilation. It is essential for nurses to have a clear understanding of the rationale behind interventions to provide effective patient care.
In the management process, the periodic checking of the results of action to make sure that it coincides with the goal of the institution is termed as:
- A. Planning
- B. Evaluating
- C. Directing
- D. Organizing
Correct Answer: B
Rationale: The correct answer is B: Evaluating. Evaluating involves the periodic checking of results to ensure they align with the institution's goals. Planning (choice A) is about setting goals and determining the actions required to achieve them. Directing (choice C) involves overseeing and guiding the activities of individuals or teams to accomplish goals. Organizing (choice D) is about arranging resources and tasks to achieve objectives. In the context of the management process described, evaluating best fits the action of checking results against goals.
During the Emergent phase of a burn, the most fatal electrolyte imbalance in a burned client is:
- A. Hypokalemia
- B. Hyperkalemia
- C. Hypernatremia
- D. Hyponatremia
Correct Answer: A
Rationale: During the Emergent phase of burns, the most fatal electrolyte imbalance is Hypokalemia. This is due to the shift of potassium from the intracellular space to the extracellular space, leading to low potassium levels in the blood. Choices B, C, and D are incorrect because Hyperkalemia, Hypernatremia, and Hyponatremia are not typically associated with the Emergent phase of burns and do not pose the same level of risk as Hypokalemia in this context.
In an extreme situation and when no other resident or intern is available, should a nurse receive telephone orders, the order has to be correctly written and signed by the physician within:
- A. 24 hours
- B. 36 hours
- C. 48 hours
- D. 12 hours
Correct Answer: B
Rationale: In an extreme situation where no other resident or intern is available, if a nurse receives telephone orders, the order has to be correctly written and signed by the physician within 36 hours. This time frame ensures timely documentation and validation of the orders. Choice A (24 hours) is too short a period for busy physicians to fulfill the task. Choice C (48 hours) is too long and delays the incorporation of physician orders into the patient's care plan. Choice D (12 hours) may not provide enough time for the physician to review and sign the order, especially in situations where immediate attention is not required.