Trainer 2

The client with type 1 diabetes asks the nurse why the health care provider prescribed short-acting insulin instead of intermediate-acting insulin. Which response by the nurse is best? 1. "More injections are required with intermediate-acting insulin than with short-acting insulin." 2. "Hypoglycemia and hyperglycemia are more common with intermediate-acting insulin." 3. "Development of eye and kidney damage is less likely with short-acting insulin." 4. "Blood glucose levels can be controlled more accurately with short-acting insulin."

"Blood glucose levels can be controlled more accurately with short-acting insulin." — tighter blood glucose control occurs with short-acting insulin, especially initially

The nurse prepares the client for an IV pyelogram (IVP) scheduled in 2 hours. The nurse contacts the health care provider if the client makes which statement? 1. "I take metformin for type 2 diabetes." 2. "I completed the bowel prep last evening." 3. "I ate a light meal last evening." 4. "I had an IVP 3 years ago."

"I take metformin for type 2 diabetes." — should discontinue 48 hours prior to procedure, contrast media can cause life-threatening lactic acidosis

The client has a history of hypertension and angle-closure glaucoma. Which medication order does the nurse question? 1. Propranolol 80 mg PO QID. 2. Verapamil 40 mg PO TID. 3. Tetrahydrozoline 2 drops in each eye TID. 4. Timolol 1 drop in each eye once daily.

Tetrahydrozoline 2 drops in each eye TID — contraindicated; ophthalmic vasoconstrictor, contraindicated with angle-closure glaucoma; use cautiously with hypertension

The nursing team consists of one RN, two LPNs/LVNs, and three nursing assistive personnel (NAP). The RN cares for which client? 1. The client with a chest tube who is ambulating in the hall. 2. The client with a colostomy requiring assistance with an irrigation. 3. The client with a right-sided stroke requiring assistance with bathing. 4. The client declining medication to treat cancer of the colon.

The client declining medication to treat cancer of the colon - requires assessment skills by the RN

The nurse cares for the client diagnosed with Ménière's syndrome. The nurse stands directly in front of the client when speaking. Which best describes the rationale for the nurse's position? 1. This enables the client to read the nurse's lips. 2. The client does not have to turn the head to see the nurse. 3. The nurse will have the client's undivided attention. 4. There is a decrease in client's peripheral visual field.

The client does not have to turn the head to see the nurse — by decreasing movement of client's head, vertigo attacks may be decreased

PKU (phenylketonuria) test

The initial specimen should be collected as close to discharge as possible but not later than 7 days. - if initial specimen is collected before newborn is 24 hours old, a repeat test should be performed by 2 weeks of age

Purpose of continuous bladder irrigation

To prevent blood clots after a TURP (treatment for BPH) and to enable urine to keep flowing

Duodenum ulcer pain

Two to three hours after a meal. During the night. Prior to the ingestion of food

Gastric ulcer pain

occurs 30 minutes to 90 minutes after eating, not at night, and doesn't go away with food

The nurse plans discharge teaching for the client after a lumbar laminectomy. Which muscle or muscles does the nurse instruct the client to exercise regularly? 1. Anal sphincter. 2. Abdominal. 3. Trapezius. 4. Rectus femoris.

Abdominal — strengthening the abdominal muscles adds support for the muscles supporting the lumbar spine

Buerger's disease symptom

Digital sensitivity to cold Intermittent claudication (pain with exercise) vasculitis of blood vessels in upper and lower extremities

The client is admitted with a tentative diagnosis of late stage AIDS dementia complex. The nursing assessment is most likely to reveal which finding? 1. Hyperactive deep tendon reflexes. 2. Peripheral neuropathy affecting the hands. 3. Disorientation to person, place, and time. 4. Impaired concentration and memory loss.

Disorientation to person, place, and time — approximately 65% of AIDS clients demonstrate a progressive dementia staged according to severity of debilitation; late stage is typified by cognitive confusion and disorientation

The nurse cares for a client during an acute manic episode. The nurse identifies which client behaviors as most characteristic of mania? Select all that apply. 1. Paranoia. 2. Grandiose delusions. 3. Somatic difficulties. 4. Difficulty concentrating. 5. Agitation. 6. Distorted perceptions.

Grandiose delusions, difficulty concentrating, agitation 1) related to schizophrenia. 2) CORRECT - delusions of grandeur are common during mania. 3) related to personality disorders. 4) CORRECT - due to excessive activity. 5) CORRECT - clients are constantly in motion. 6) related to depression.

The nurse plans care for the 20-year-old client. Which psychosocial stage does the nurse identify as the priority to consider? 1. Identity versus identity diffusion. 2. Intimacy versus isolation. 3. Integrity versus despair and disgust. 4. Industry versus inferiority.

Intimacy vs. isolation

The nurse cares for the client diagnosed with a recurrent urinary tract infection. The health care provider prescribes ciprofloxacin. The nurse instructs the client to limit intake of which fluid? 1. Milk. 2. Cranberry juice. 3. Water. 4. Tea.

Milk - should limit intake of alkaline foods and fluids

The client develops a low intestinal obstruction. The nurse anticipates which findings? Select all that apply. 1. Nausea. 2. Vomiting. 3. Explosive diarrhea. 4. Tarry stool 5. Abdominal distention. 6. Rectal bleeding.

Nausea, vomiting, abdominal distention

The nurse cares for the client diagnosed with hypoparathyroidism. Which nursing action has the highest priority for this client? 1. Develop a teaching plan. 2. Plan measures to deal with cardiac dysrhythmias. 3. Take measures to prevent a respiratory infection. 4. Assess laboratory results.

Plan measures to deal with cardiac dysrhythmias — cardiac dysrhythmias related to low serum calcium would be the highest priority

Hypocalcemia signs and symptoms

Positive Trousseau's sign is indicative of neuromuscular hyperreflexia associated with hypocalcemia

The nurse observes the student nurse auscultate the right middle lobe (RML) lung of a client. The nurse knows the student nurse is auscultating correctly if the stethoscope is placed in which position? 1. Posterior and anterior base of right side. 2. Right anterior chest between the fourth and sixth intercostal spaces. 3. Left of the sternum, midclavicular, at fifth intercostal space. 4. Posterior chest wall, midaxillary, right side.

RML is found in the right anterior chest between the fourth and sixth intercostal spaces. - cannot be auscultated posteriorly

Miller-Abbott tube

Removes fluid and gas from the small intestine - intestinal decompression

A continent adult client undergoes admission to the hospital with a diagnosis of hepatitis A. Which precautions does the nurse include in the client's overall care during hospitalization? 1. Contact precautions. 2. Airborne precautions. 3. Standard precautions. 4. Droplet precautions.

Standard precautions should be used on everyone. Hepatitis A is usually transmitted person-to-person through the fecal-oral route or consumption of contaminated food or water. Contact precautions would only be required if the client was incontinent or diapered.

Hypercalcemia

Constipation Depressed reflexes Decreased muscle strength.