A man with a history of diabetes and chronic lung disease is admitted to the hospital with prostate cancer. He has all the following symptoms. Which should the nurse address first?

Correct Answer: C

Rationale: In this case, the nurse should address the respiratory rate of 36 breaths per minute first, as it indicates potential respiratory distress in a patient with chronic lung disease. Rapid and shallow breathing could be a sign of worsening lung function or complications such as pneumonia, which require immediate attention to ensure adequate oxygenation and prevent further deterioration. Monitoring and addressing the patient's respiratory status are crucial in preventing respiratory failure and other serious complications.

Correct Answer: B

Rationale: A stabilized newborn generally has an apical heart rate in the range of 80 to 100 beats per minute. This range is considered normal for a healthy newborn. It is important for the nurse to monitor the newborn's heart rate closely to ensure that it remains within this expected range. Any significant deviation from this range may indicate an underlying health issue that needs to be addressed promptly. Monitoring heart rate is a critical aspect of newborn care, especially in the immediate postnatal period.

Correct Answer: C

Rationale: Clients with autoimmune disorders often experience periods of immunosuppression, where their immune system is compromised and less effective at fighting off infections. Being in crowded places increases the risk of exposure to infectious agents, which can pose a greater threat to individuals with weakened immune systems. It is important for clients with autoimmune disorders to avoid crowds during periods of immunosuppression to reduce the risk of infections and other complications.

Correct Answer: D

Rationale: Streptococcus viridans is the most common causative agent of bacterial endocarditis. This group of bacteria consists of various species, including S. sanguinis and S. mutans, which normally reside in the oral cavity and are commonly associated with endocarditis following dental procedures. Streptococcus viridans can enter the bloodstream due to dental work, oral infections, or trauma to the oral tissues, and cause infective endocarditis by adhering to damaged heart valves or endocardium. Staphylococcus aureus and Enterococcus species are other common pathogens associated with endocarditis, but Streptococcus viridans remains the most prevalent causative agent.

Correct Answer: C

Rationale: The nurse's best reply would be option C, "Your body does not make insulin, so the insulin injections help to replace it." This response directly addresses Tara's question about why she needs insulin injections instead of pills. In type 1 diabetes mellitus, the body's immune system mistakenly attacks the beta cells in the pancreas that produce insulin. As a result, individuals with type 1 DM do not produce insulin, so they require insulin injections to replace the missing hormone. Unlike type 2 diabetes where oral medications can be used to manage the condition, individuals with type 1 diabetes rely on insulin injections to regulate their blood glucose levels.

Correct Answer: C

Rationale: In this case, the nurse should address the respiratory rate of 36 breaths per minute first, as it indicates potential respiratory distress in a patient with chronic lung disease. Rapid and shallow breathing could be a sign of worsening lung function or complications such as pneumonia, which require immediate attention to ensure adequate oxygenation and prevent further deterioration. Monitoring and addressing the patient's respiratory status are crucial in preventing respiratory failure and other serious complications.

Correct Answer: C

Rationale: The best statement explaining why the nurse should instruct the client to take prednisone (Deltasone) in the morning is that morning administration mimics the body's natural corticosteroid secretion pattern. Cortisol, a natural corticosteroid, is highest in the morning and decreases throughout the day. By taking prednisone in the morning, the client aligns the medication's peak effects with the body's natural cortisol levels, which can help reduce the risk of disrupting the body's internal rhythm and minimize potential side effects. This timing also helps achieve optimal therapeutic effects while minimizing the risk of adrenal suppression and other adverse effects associated with corticosteroid use.

Correct Answer: B

Rationale: Mild reactions like swelling, tenderness, low-grade fever, and malaise are common after DTaP vaccination and can be managed with supportive care.

Correct Answer: A

Rationale: Corticosteroids are not typically used in the treatment of heart insufficiency. The mainstay of treatment for heart insufficiency includes medications like oxygen, digoxin, diuretics, and sometimes blood transfusions of packed red blood cells. Corticosteroids are more commonly used to reduce inflammation and immune responses in conditions like asthma, arthritis, and certain autoimmune diseases.