Nokea
Your client has a doctor's order that reads 'advance diet as tolerated'. This client has returned from the recovery room after an appendectomy and he states, 'I am hungry'. What would you offer this client to consume?
- A. Cheese and crackers
- B. Apple sauce
- C. Chicken broth
- D. A peanut butter sandwich
Correct Answer: C
Rationale: Chicken broth is a suitable option for a post-appendectomy patient beginning to tolerate oral intake. It is clear liquid and easily digestible, making it a gentle choice for someone who has just returned from surgery. Cheese and crackers, apple sauce, and a peanut butter sandwich are not ideal options for an individual who needs to start with a light and easily digestible diet.
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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 is providing an in-service about client rights for a group of nurses. Which of the following statements should the nurse include in the service?
- A. A nurse can disclose information to a family member with the client's permission
- B. A nurse can apply restraints on an as-needed basis
- C. A nurse can administer medications without consent to a client as part of a research study
- D. A nurse is responsible for informing clients about treatment options
Correct Answer: A
Rationale: The correct statement to include in the in-service about client rights is that a nurse can disclose information to a family member with the client's permission. This respects the client's autonomy and privacy. Choice B is incorrect because restraints should only be applied based on a specific assessment and order, not on an as-needed basis. Choice C is incorrect as administering medications without consent is a violation of ethical principles and legal standards. Choice D is incorrect because while nurses should educate clients about treatment options, the ultimate decision lies with the client after being informed.
Select the tactile sensation that is accurately paired with its description or procedure for testing.
- A. Fine motor coordination: The use of the fingers
- B. Stereognosis: Equal hearing in both ears
- C. Two-point discrimination: The nurse gently pricks the patient's skin
- D. Gross motor function: The use of the lower limbs
Correct Answer: C
Rationale: The correct answer is C: Two-point discrimination: The nurse gently pricks the patient's skin. Two-point discrimination assesses the ability to discern two points touched simultaneously on the skin. Fine motor coordination (Choice A) refers to the precise movements of small muscles, not related to tactile sensation. Stereognosis (Choice B) is the ability to recognize objects by touch, not equal hearing in both ears. Gross motor function (Choice D) involves the coordination of large muscle groups, not specifically related to tactile sensation testing.
Jansen is receiving metformin (Glucophage). What will be the best plan of the nurse with regard to patient education with this drug? Select one that does not apply.
- A. It stimulates the pancreas to produce more insulin.
- B. It must be taken after meals.
- C. It decreases sugar production in the liver.
- D. It inhibits absorption of carbohydrates.
Correct Answer: A
Rationale: The correct choice that does not apply is A. Metformin does not stimulate the pancreas to produce more insulin; instead, it works by decreasing sugar production in the liver, inhibiting carbohydrate absorption, and reducing insulin resistance. It is recommended to take metformin with meals to reduce gastrointestinal side effects. Option B is incorrect as metformin is usually taken with meals. Option D is also incorrect as metformin does not inhibit the absorption of carbohydrates.
A patient is admitted to the emergency department with hypovolemia. Which IV solution should the nurse anticipate administering?
- A. 3% sodium chloride
- B. 10% dextrose in water
- C. 0.45% sodium chloride
- D. Lactated Ringer's solution
Correct Answer: D
Rationale: Lactated Ringer's solution is the most suitable IV solution for a patient with hypovolemia. It is a balanced crystalloid solution containing electrolytes such as sodium, chloride, potassium, calcium, and lactate, which closely resemble the body's natural fluids. This solution helps to restore intravascular volume and electrolyte balance in hypovolemic patients. Choice A, 3% sodium chloride, is a hypertonic solution used for specific situations like severe hyponatremia or cerebral edema, not typically for hypovolemia. Choice B, 10% dextrose in water, is a hypertonic solution primarily used for providing calories and free water, not for volume expansion. Choice C, 0.45% sodium chloride, is a hypotonic solution used for conditions like hypernatremia or as maintenance fluid, not for hypovolemia.