A male client with Type 1 diabetes mellitus takes a combination of short acting and intermediate acting insulin. The client complains of headaches when awakening and his blood glucose average for the past week has been 210. The nurse recognizes the client is experiencing a daily Somogyi, or rebound...
MED SURG HESI BSN 266 EXAM STUDY GUIDE WITH COMPLETE SOLUTIONS GRADED A 2024 A male client with Type 1 diabetes mellitus takes a combination of short acting and intermediate acting insulin. The client complains of headaches when awakening and his blood glucose average for the past week has been 210. The nurse recognizes the client is experiencing a daily Somogyi, or rebound effect. Which dosing method is likely to relieve these symptoms? Move the PM intermediate - acting dose to bedtime. When obtaining a throat culture from a 6 year old with possible strepococcal infection, which action is most important for the nurse to implement? Swab the child's erythematous oropharyngeal surfaces or tonsilar pustules. The nurse is caring for a 42 -year-old male client who is excreting less sodium than he is consuming. If this condition continues, what complication can the nurse expect this client to exhibit? edema Which condition would likely cause secondary polycythemia? High altitude exposure. An infant is treated for intussusception with hydrostatic reduction. What instruction should the nurse include in the parents’ teaching plan? s/s of reocurrence A client with type 1 diabetes mellitus is prescribed 10 units of intermediate acting insulin to be administered at bedtime. For which health problem is the insulin being administered at this time of day? dawn phenomenon The nurse is obtaining a throat culture of a client’s posterior oropharyngeal region. For which health problem will this specimen be used to diagnose? strep throat A middle -aged male client is being evaluated for lower extremity edema. Which laboratory value will be used to aid in determining the cause of this client’s manifestation? serum sodium A client is diagnosed with secondary polycythemia. Which health condition contributed to the development of this secondary problem? hypovolemia A client in the oliguric phase of acute renal failure (ARF) has a 24 hour urine output of 400ml. nurse should allow this client to have how much oral intake during the next 24 hours? limit oral intake to 900. to 1000ml A female client on the mental health unit tells the nurse that her roommate is sitting on the bathroom floor with superficial cuts on her wrists. The nurse cleans and assesses the client’s wrists and asks her what happened. She doesn’t respond. Next? take the client to a room for supervision by staff What assessment technique should the nurse use to monitor a client for a common untoward effect of phenytoin (Dilantin)? inspection of the mouth The nurse is preparing to administer an IM dose of Vitamin B1 (thiamine) to a male client experiencing acute alcohol withdrawal and peripheral neuritis. The client belligerently states, “what do you think you’re doing?” Response? "This shot will help relieve the pain in your feet When administering an intramuscular injection containing 3 ml of a painful medication, Intervention? select a large, deep muscle mass Locate the optic disk the really light area on the right When completing a mental health assessment, the nurse wishes to obtain information about a client’s insight and judgment. Which interview technique is most useful in assessing these mental abilities have the client describe what should be done if a child was observed alone in a locked car on a hot day An adult Muslim client with ulcerative colitis was admitted to the post -surgical unit earlier today following a bowel resection with temporary colostomy. Which intervention is most important for the nurse to implement? assign a care provider of the same gender The parents of a 6 -year-old recently diagnosed with Duchene muscular dystrophy tell the nurse that their child wants to continue attending swimming classes. How should the nurse respond? encourage the parents to allow the child to continue attending swimming lessons with supervision The nurse initiates a one -to-one relationship with a 35 -year-old depressed female client who was recently admitted to the psychiatric facility. Which nursing action is most effective in promoting the development of a therapeutic relationship? ensure that scheduled appointments begin according to the schedule An 18 -year-old female client is admitted to the unit after ingesting an overdose of Phenobarbital (Luminal). She is unresponsive and ABG results are: pH 7.18, PaCO2 60 mmHg, and HCO3 26 mEq/L. Which interpretation of the client’s ABG results by the nurse i s accurate? respiratory acidosis, uncompensated A male client with multiple myeloma is admitted with pneumonia and pancytopenia. The nurse reviews the complete blood cell count findings and identifies a platelet count of 20,000 cells/mm3. Which intervention should the nurse include in the client’s plan of care? avoid intramuscular injections The nurse is planning care for a 48 -year-old client, diagnosed with schizophrenia at age 25, who has been taking antipsychotic drugs since diagnosis. Long -term use of these drugs is associated with which side effect? tardive dyskinesia What instruction is most important for the nurse to provide a client with neutropenia? avoid sources of potential infection A client with acute laryngitis reports feeling “short of breath”. The nurse assesses that the client’s respiratory rate has increased from 16/minute to 28/minute. What intervention should the nurse implement? assess the client for stridor and increased respiratory effort When caring for a client who had a craniotomy yesterday for removal of a pituitary tumor, which finding indicates to the nurse that further information is needed? urine output for 8 hours is 2000 ml with a specific gravity of 1.001 The nurse is working with an interdisciplinary group to write procedures for assessment of clients from a multiracial inner city population. The guidelines include a statement that reads, “Remember that all Hispanic clients may not wish to give personal me dical information to a stranger.” Which action should the nurse take? recommend changing the language that stereotypes one ethnic group A 6-month -old client is diagnosed with intussusception. For which medical intervention will the nurse prepare this client? an enema The nurse is reviewing the medication history of a client who is demonstrating tardive dyskinesia. Which medication classification will the nurse focus on during this review? antipsycotics A client receiving chemotherapy as part of cancer treatment has developed an upper respiratory infection. The nurse realizes the cause of this infection may be due to: low wbc count The nurse has explained safety precautions and infant care to a primigravida mother and observes the mother as she gives care to her newborn during the first two days of rooming -in. which action indicates the mother understands instructions? positions the infant supine in the crib to sleep HCP prescribes amoxicillin (Amoxil) 1.5 grams PO daily, in equally divided doses to be administered every 8 hours. The medication is available in a bottle labeled, “Amoxicillin (Amoxil) suspension 200mg/5ml.” How many ml should nurse administer every 8 hou rs? 12.5 20 year old female client tells nurse her menstrual periods occur about every 28 days, and her breasts are quite tender when her flow is heavy. She also states that she performs her breast self -exam on the first day of every month. Action?
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