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Questions 148

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Question 1 of 5

A 15-year-old primigravida is admitted with a tentative diagnosis of HELLP syndrome. Which laboratory finding is associated with HELLP syndrome?

Correct Answer: D

Rationale: HELLP syndrome is characterized by hemolysis, elevated liver enzymes, and low platelets, so elevated hepatic enzymes are a key finding.

Question 2 of 5

The nurse administers 6 units of Humalog (lispro) insulin sub-q to a client at 8:30 a.m. The nurse knows to reassess the client and check for a possible hypoglycemic reaction at

Correct Answer: B

Rationale: Humalog (lispro) is rapid-acting insulin with a peak effect at 1-2 hours. Checking at 9:30 a.m. (1 hour post-administration) aligns with the onset of action to monitor for hypoglycemia.

Question 3 of 5

The nurse should carefully monitor the client for which common dysrhythmia that can occur during suctioning?

Correct Answer: A

Rationale: Suctioning can stimulate the vagus nerve, leading to bradycardia due to parasympathetic activation, especially in clients with tracheostomies or endotracheal tubes.

Question 4 of 5

The nurse is developing a care plan for a client with hepatitis A. The nurse knows that the primary routes of transmission of this hepatitis virus are which of the following? Select all that apply.

Correct Answer: C,D

Rationale: Hepatitis A is transmitted primarily via the fecal-oral route, through contaminated food or water (
D) and feces (
C).

Question 5 of 5

The client is admitted to the unit after a cholescystectomy. Montgomery straps are utilized with this client. The nurse is aware that Montgomery straps are utilized on this client because:

Correct Answer: B

Rationale: Montgomery straps are used to secure dressings in a way that allows for frequent changes without removing adhesive, which is common after a cholecystectomy due to drainage or wound care needs.

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