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1. The nurse is taking a health history from a 29-year-old pregnant patient at the first prenatal visit. The patient reports no personal history of diabetes but has a parent who is diabetic. Which action will the nurse plan to take first?
- A. Teach the patient about administering regular insulin.
- B. Schedule the patient for a fasting blood glucose level.
- C. Discuss an oral glucose tolerance test for the twenty-fourth week of pregnancy.
- D. Provide teaching about an increased risk for fetal problems with gestational diabetes.
Correct answer: B
Rationale: The correct answer is B. Given the family history of diabetes, the initial action the nurse should take is to schedule the patient for a fasting blood glucose level. This will help in assessing if the patient has developed gestational diabetes. Choice A is incorrect because teaching about administering regular insulin is premature without confirming the diagnosis. Choice C is incorrect as an oral glucose tolerance test is typically done earlier in pregnancy. Choice D is incorrect as discussing fetal problems related to gestational diabetes should come after a confirmed diagnosis.
2. The nurse is interviewing a new patient with diabetes who receives rosiglitazone (Avandia) through a restricted access medication program. What is most important for the nurse to report immediately to the health care provider?
- A. The patient's blood pressure is 154/92.
- B. The patient has a history of emphysema
- C. The patient's blood glucose is 86 mg/dL.
- D. The patient has chest pressure when walking
Correct answer: D
Rationale: Chest pressure while walking may indicate heart-related issues such as angina or a heart attack. Rosiglitazone (Avandia) has been associated with increased risks of cardiovascular events like heart failure. Given these risks, chest pressure is an urgent symptom that must be reported immediately to prevent potentially life-threatening complications.
3. A nurse is caring for a client who has a nasogastric (NG) tube and is receiving intermittent feedings through an open system. Which of the following actions should the nurse take first?
- A. Make sure the enteral formula is at room temperature.
- B. Wipe the top of the formula can with alcohol.
- C. Rinse the feeding bag with water between feedings.
- D. Tell the client to keep the head of the bed elevated at least 30�
Correct answer: B
Rationale:
4. An RN is explaining to a student nurse what professionalism in nursing means. Which of the following statements, if made by the student nurse, demonstrates teaching has been successful?
- A. Commitment to others means I should be honest and accountable for my actions.
- B. I should encourage my fellow nurses to talk when they are having a bad day.
- C. I should be flexible with myself and my fellow nurses when it comes to the dress code.
- D. If I need a day off, I should promptly call in sick to give my manager plenty of time to find a replacement.
Correct answer: A
Rationale: Commitment to others involves accountability for one�s actions, lifelong learning, and commitment to colleagues.
5. A 26-year-old patient with diabetes rides a bicycle to and from work every day. Which site should the nurse teach the patient to administer the morning insulin?
- A. Thigh
- B. Buttock
- C. Abdomen
- D. Upper arm
Correct answer: C
Rationale: The correct answer is the abdomen. When a patient engages in physical activities like riding a bicycle, the abdomen is a suitable site for insulin administration due to the consistent absorption rate. The subcutaneous tissue in the abdomen allows for more predictable insulin absorption compared to other sites. The thigh is also a common site for insulin injection but may not be ideal for this patient due to the physical activity involved. The buttock and upper arm are not preferred sites for insulin injection as they can have variable absorption rates and may not be as convenient for self-administration.
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