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Questions 163

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Extract:

Laboratory Reference Range
Glucose (fasting)
70-110 mg/dL
(3.9-6.1 mmol/L)


Question 1 of 5

The nurse has received information from unlicensed assistive personnel about assigned client situations. Which of the following situations should the nurse address first?

Correct Answer: D

Rationale: A full sharps container poses an immediate safety hazard and must be addressed first. Normal glucose , a discarded void , and procedure clarification are less urgent.

Extract:


Question 2 of 5

A client with Cushing's syndrome should be instructed to:

Correct Answer: B

Rationale: A client with Cushing's syndrome has adrenocortical hypersecretion, so she retains sodium and water. The client may drink alcohol in moderation, so answer A is incorrect, and there is no need to eat more green vegetables or limit protein, so answers C and D are incorrect.

Question 3 of 5

A nurse from the float pool is giving medications on a pediatric unit and is to give medications to a 2-year-old child in room 534, bed B. The child in that room does not have an identification band. What is the best action for the nurse to take?

Correct Answer: C

Rationale: Refusing to give medication without proper identification ensures safety, as a 2-year-old cannot reliably confirm identity.

Question 4 of 5

The practical nurse is assisting the registered nurse during admission of a client with heart failure-related fluid overload. Which action should be completed first?

Correct Answer: B

Rationale: Assessing breath sounds is the first step to evaluate the extent of fluid overload and guide interventions in heart failure. Oxygen , monitoring , and IV insertion follow based on findings.

Question 5 of 5

Four clients arrive in the urgent care clinic. Which does the nurse anticipate to be the priority for intervention?

Correct Answer: A

Rationale: The child who is confused and irritable with missing glyburide pills suggests a potential hypoglycemic emergency due to sulfonylurea overdose, which requires immediate intervention to prevent severe complications like seizures or coma.

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