The nurse is performing nasotracheal suctioning. After suctioning the client's trachea
for fifteen seconds, large amounts of thick yellow secretions return. What action
should the nurse implement next?
A) Encourage the client to cough to help loosen secretions.
B) Advise the client to increase the intake of oral fluids.
C) Rotate the suction catheter to obtain any remaining secretions.
D) Re-oxygenate the client before attempting to suction again.
Give this one a try later!
D) Re-oxygenate the client before attempting to suction again
Suctioning should not be continued for longer than ten to fifteen seconds,
since the client's oxygenation is compromised during this time (D). (A, B,
and C) may be performed after the client is re-oxygenated and additional
suctioning is performed.
,The nurse is instructing a client with high cholesterol about diet and life style
modification. What comment from the client indicates that the teaching has been
effective?
A) If I exercise at least two times weekly for one hour, I will lower my cholesterol.
B) I need to avoid eating proteins, including red meat.
C) I will limit my intake of beef to 4 ounces per week.
D) My blood level of low density lipoproteins needs to increase.
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C) I will limit my intake of beef to 4 ounces per week
Limiting saturated fat from animal food sources to no more than 4 ounces
per week (C) is an important diet modification for lowering cholesterol. To
be effective in reducing cholesterol, the client should exercise 30 minutes
per day, or at least 4 to 6 times per week (A). Red meat and all proteins do
not need to be eliminated (B) to lower cholesterol, but should be restricted
to lean cuts of red meat and smaller portions (2-ounce servings). The low
density lipoproteins (D) need to decrease rather than increase
Desmopressin
Why?
Give this one a try later!
The nurse is caring for a client with diabetes insipidus. The nurse should
anticipate the administration of:
An unlicensed assistive personnel (UAP) places a client in a left lateral position prior
to administering a soap suds enema. Which instruction should the nurse provide the
,UAP?
A) Position the client on the right side of the bed in reverse Trendelenburg.
B) Fill the enema container with 1000 ml of warm water and 5 ml of castile soap.
C) Reposition in a Sim's position with the client's weight on the anterior ilium.
D) Raise the side rails on both sides of the bed and elevate the bed to waist level.
Give this one a try later!
C) Reposition in a Sim's position with the client's weight on the anterior ilium
The left sided Sims' position allows the enema solution to follow the
anatomical course of the intestines and allows the best overall results, so
the UAP should reposition the client in the Sims' position, which distributes
the client's weight to the anterior ilium (C). (A) is inaccurate. (B and D)
should be implemented once the client is positioned
A male client tells the nurse that he does not know where he is or what year it is. What
data should the nurse document that is most accurate?
A) demonstrates loss of remote memory.
B) exhibits expressive dysphasia.
C) has a diminished attention span.
D) is disoriented to place and time.
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D) is disoriented to place and time
The client is exhibiting disorientation (D). (A) refers to memory of the distant
past. The client is able to express himself without difficulty (B), and does not
demonstrate a diminished attention span (C).
, Regular(Humalin), Semilente
Onset: 1-1.5 hr
Duration: 4-6 hours
Peak: 2-3 hours
Give this one a try later!
Short Acting
Serum Potassium
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After being sick for 3 days, a client with a history of diabetes mellitus is
admitted to the hospital with diabetic ketoacidosis (DKA). The nurse should
evaluate which diagnostic test results to prevent arrhythmias?
Ketones accumulate in the blood and urine when fat breaks down. Ketones signal a
deficiency of insulin that will cause the body to start to break down stored fat for
energy.
Explanation:
Ketones (or ketone bodies) are byproducts of fat breakdown, and they accumulate in
the blood and urine. Ketones in the urine signal a deficiency of insulin and control of
type 1 diabetes is deteriorating. When almost no effective insulin is available, the body
starts to break down stored fat for energy
Give this one a try later!
A nurse is teaching a patient recovering from diabetic ketoacidosis (DKA)
about management of "sick days." The patient asks the nurse why it is
for fifteen seconds, large amounts of thick yellow secretions return. What action
should the nurse implement next?
A) Encourage the client to cough to help loosen secretions.
B) Advise the client to increase the intake of oral fluids.
C) Rotate the suction catheter to obtain any remaining secretions.
D) Re-oxygenate the client before attempting to suction again.
Give this one a try later!
D) Re-oxygenate the client before attempting to suction again
Suctioning should not be continued for longer than ten to fifteen seconds,
since the client's oxygenation is compromised during this time (D). (A, B,
and C) may be performed after the client is re-oxygenated and additional
suctioning is performed.
,The nurse is instructing a client with high cholesterol about diet and life style
modification. What comment from the client indicates that the teaching has been
effective?
A) If I exercise at least two times weekly for one hour, I will lower my cholesterol.
B) I need to avoid eating proteins, including red meat.
C) I will limit my intake of beef to 4 ounces per week.
D) My blood level of low density lipoproteins needs to increase.
Give this one a try later!
C) I will limit my intake of beef to 4 ounces per week
Limiting saturated fat from animal food sources to no more than 4 ounces
per week (C) is an important diet modification for lowering cholesterol. To
be effective in reducing cholesterol, the client should exercise 30 minutes
per day, or at least 4 to 6 times per week (A). Red meat and all proteins do
not need to be eliminated (B) to lower cholesterol, but should be restricted
to lean cuts of red meat and smaller portions (2-ounce servings). The low
density lipoproteins (D) need to decrease rather than increase
Desmopressin
Why?
Give this one a try later!
The nurse is caring for a client with diabetes insipidus. The nurse should
anticipate the administration of:
An unlicensed assistive personnel (UAP) places a client in a left lateral position prior
to administering a soap suds enema. Which instruction should the nurse provide the
,UAP?
A) Position the client on the right side of the bed in reverse Trendelenburg.
B) Fill the enema container with 1000 ml of warm water and 5 ml of castile soap.
C) Reposition in a Sim's position with the client's weight on the anterior ilium.
D) Raise the side rails on both sides of the bed and elevate the bed to waist level.
Give this one a try later!
C) Reposition in a Sim's position with the client's weight on the anterior ilium
The left sided Sims' position allows the enema solution to follow the
anatomical course of the intestines and allows the best overall results, so
the UAP should reposition the client in the Sims' position, which distributes
the client's weight to the anterior ilium (C). (A) is inaccurate. (B and D)
should be implemented once the client is positioned
A male client tells the nurse that he does not know where he is or what year it is. What
data should the nurse document that is most accurate?
A) demonstrates loss of remote memory.
B) exhibits expressive dysphasia.
C) has a diminished attention span.
D) is disoriented to place and time.
Give this one a try later!
D) is disoriented to place and time
The client is exhibiting disorientation (D). (A) refers to memory of the distant
past. The client is able to express himself without difficulty (B), and does not
demonstrate a diminished attention span (C).
, Regular(Humalin), Semilente
Onset: 1-1.5 hr
Duration: 4-6 hours
Peak: 2-3 hours
Give this one a try later!
Short Acting
Serum Potassium
Give this one a try later!
After being sick for 3 days, a client with a history of diabetes mellitus is
admitted to the hospital with diabetic ketoacidosis (DKA). The nurse should
evaluate which diagnostic test results to prevent arrhythmias?
Ketones accumulate in the blood and urine when fat breaks down. Ketones signal a
deficiency of insulin that will cause the body to start to break down stored fat for
energy.
Explanation:
Ketones (or ketone bodies) are byproducts of fat breakdown, and they accumulate in
the blood and urine. Ketones in the urine signal a deficiency of insulin and control of
type 1 diabetes is deteriorating. When almost no effective insulin is available, the body
starts to break down stored fat for energy
Give this one a try later!
A nurse is teaching a patient recovering from diabetic ketoacidosis (DKA)
about management of "sick days." The patient asks the nurse why it is
