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Questions 148

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Question 1 of 5

A client with newly diagnosed type I diabetes mellitus is being seen by the home health nurse. The physician orders include: 1,200-calorie ADA diet, 15 units of NPH insulin before breakfast, and check blood sugar qid. When the nurse visits the client at 5 PM, the nurse observes the man performing a blood sugar analysis. The result is 50 mg/dL. The nurse would expect the client to be

Correct Answer: A

Rationale: symptoms of hypoglycemia, normal blood sugar 70-110 mg/dL

Question 2 of 5

The '5 A's' of smoking cessation intervention begin with which of the following?

Correct Answer: B

Rationale: The 5 A's begin with Ask (
B), identifying tobacco use at every visit, followed by Advise, Assess, Assist, and Arrange.

Question 3 of 5

The nurse is changing the ties of the client with a tracheotomy. The safest method of changing the tracheotomy ties is to:

Correct Answer: A

Rationale: Applying the new tie before removing the old one ensures the tracheotomy tube remains secure, preventing accidental dislodgement.

Question 4 of 5

Which of the following tasks are appropriate for the nurse to delegate to unlicensed assistive personnel? Select all that apply.

Correct Answer: B,C,E

Rationale: Unlicensed assistive personnel can perform routine tasks like checking routine vital signs (
B), measuring urinary output (
C), and assisting with ambulation (E). Checking vital signs in an acutely ill client (
A) and monitoring a transfusion (
D) require a nurse's assessment skills.

Question 5 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.

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