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Questions 164

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Extract:

Laboratory reference ranges
Glucose (random)
71-200 mg/dL
(3.9–11.1 mmol/L)


Question 1 of 5

The nurse is caring for assigned clients. Which of the following clients should the nurse check first?

Correct Answer: C

Rationale: A blood glucose level of 55 mg/dL indicates severe hypoglycemia, a life-threatening condition requiring immediate intervention to prevent seizures or coma.

Extract:


Question 2 of 5

The nurse is teaching a group of adults about modifiable cardiac risk factors. Which of the following should the nurse focus on first?

Correct Answer: D

Rationale: Smoking cessation. Stopping smoking is the priority for clients at risk for cardiac disease, because of its effects of reducing oxygenation and constricting blood vessels.

Extract:

Vital signs
Temperature 98.2 F (36.7 C)
Blood pressure 108/72 mm Hg
Heart rate 62/min
Respirations 16/min
SpO2 96% on room air


Question 3 of 5

A client who developed heart failure after a myocardial infarction is scheduled to be discharged this afternoon. Based on the discharge data, the nurse plans to reinforce which home care instructions? Select all that apply.

Correct Answer: A,B,E

Rationale: Taking pulse (
A), monitoring weight (
B), and reducing sodium (E) help manage heart failure by tracking symptoms, detecting fluid retention, and preventing exacerbation.

Extract:


Question 4 of 5

The nurse is caring for assigned clients. The nurse should first check the client

Correct Answer: D

Rationale: Fever, redness, and pain around pin sites suggest a possible infection at the external fixation site, which is a priority due to the risk of osteomyelitis or systemic infection.

Question 5 of 5

The nurse has an order to administer ophthalmic drops and ophthalmic ointment to a client being treated for conjunctivitis. The nurse should:

Correct Answer: B

Rationale: Applying drops first, then waiting 5 minutes before ointment, ensures proper absorption of both. Ointment first would block drops, and combining forms is unnecessary.

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