Maintaining the infusion rate of hyperalimentation solutions is a nursing responsibility. What side effects would you anticipate from too rapid infusion rate?

Correct Answer: D

Rationale: Rationale: 1. Rapid infusion of hyperalimentation solutions can lead to circulatory overload due to increased fluid volume in the circulatory system. 2. Circulatory overload can result in symptoms such as hypertension, tachycardia, and edema. 3. Hypoglycemia can occur as a result of excess insulin release due to the sudden increase in glucose from the hyperalimentation solution. Summary: A. Cellular dehydration and potassium: Incorrect. Rapid infusion would lead to fluid overload, not dehydration. B. Hypoglycemia and hypovolemia: Incorrect. Hypovolemia is unlikely with rapid infusion, and hypoglycemia is a possible side effect. C. Potassium excess and CHF: Incorrect. Rapid infusion may cause circulatory overload, not CHF, and potassium excess is not a common side effect. D. Circulatory overload and hypoglycemia: Correct. These are the most likely side effects of rapid

Correct Answer: B

Rationale: The correct answer is B: obtaining daily weights at the same time. This is crucial in monitoring fluid retention, a common issue in heart failure patients. Daily weights help detect early signs of fluid buildup. Option A is incorrect as physical activity is important for heart failure patients. Option C is incorrect as walking 2 miles daily may be too strenuous for some heart failure patients. Option D is incorrect as a high fiber diet is beneficial, but monitoring fluid retention is more critical in this case.

Correct Answer: C

Rationale: The correct answer is C because morphine sulfate is given to a patient with pulmonary edema to reduce anxiety (i) and to reduce preload and afterload (v). Morphine sulfate does not increase blood pressure (ii), relieve chest pain (iii), or strengthen heart contractions (iv) in the context of pulmonary edema. Choice A is incorrect because it includes increasing BP, which is not a reason for giving morphine sulfate in this case. Choice B is incorrect because it includes strengthening heart contractions, which is not a reason for administering morphine sulfate. Choice D is incorrect because it includes relieving chest pain, which is not a primary purpose of giving morphine sulfate to a patient with pulmonary edema.

Correct Answer: B

Rationale: The correct answer is B, "What reasons do you think are contributing to your fatigue?" This question encourages the patient to explore and express their own thoughts and feelings, leading to a more detailed and comprehensive understanding of the underlying causes of their daytime fatigue. A: "Is there anything that you are stressed about right now that I should know?" - This question is more direct and may not necessarily prompt the patient to delve into the specific reasons for their fatigue. C: "What are your normal work hours?" - While relevant, this question focuses solely on work hours and may not uncover other potential factors contributing to the fatigue. D: "Are you sleeping 8 hours a night?" - While sleep is important, this question is too narrow and may not address other possible reasons for the fatigue.

Correct Answer: C

Rationale: The correct answer is C: Fine needle aspiration. This procedure involves inserting a thin needle into the lump to extract cells for examination. It provides a definitive diagnosis of breast cancer by analyzing the cells for cancerous features. Breast self-examination (A) is a screening tool but cannot confirm a diagnosis. Mammography (B) is used for screening and detecting abnormalities but also requires further testing for diagnosis. Chest x-ray (D) is not used to diagnose breast cancer.

Correct Answer: C

Rationale: The correct answer is C: Amount and color of sinus drainage. Assessing the amount and color of sinus drainage is crucial in evaluating the effectiveness of nursing interventions for sinusitis discomfort as it indicates the presence of infection or inflammation. Changes in color or amount can signify improvement or worsening of the condition. WBC count (A) may indicate infection but doesn't directly reflect sinusitis discomfort. Capillary refill (B) assesses circulation, not sinusitis. Comfort level (D) is subjective and can vary among individuals, making it less reliable for assessing the effectiveness of interventions.

Correct Answer: C

Rationale: The correct answer is C (50% to 55% carbohydrate, 35% fat, and 10% to 15% protein) for managing diabetes. Carbohydrates impact blood sugar levels the most, so a moderate intake is crucial. The fat percentage is lower to reduce the risk of cardiovascular issues, common in diabetics. Protein intake is moderate for muscle maintenance. Choice A has higher fat and lower carbohydrate, not ideal for diabetes. Choice B has too high carbohydrate, which can spike blood sugar. Choice D has the highest carbohydrate percentage, which is not recommended for diabetes management.

Correct Answer: B

Rationale: The correct answer is B: Clonidine (Catapres). Clonidine is known to cause headache as a side effect due to its mechanism of action affecting blood pressure regulation in the brain. Furosemide (A) is a diuretic that typically causes electrolyte imbalances, not headaches. Atenolol (C) is a beta-blocker used for hypertension, which can cause fatigue but not typically headaches. Adalat (D) is a calcium channel blocker that usually causes peripheral edema, not headaches.

Correct Answer: A

Rationale: Correct Answer: A Rationale: 1. Aseptic technique prevents infection at IV site. 2. TPN is a high-risk solution, requiring strict aseptic administration. 3. Contaminated site can lead to sepsis or other serious complications. 4. Choice B increases risk of contamination. 5. Choice C increases risk of bacterial growth. 6. Choice D may introduce air or contamination. Summary: Choice A is correct as it emphasizes infection prevention. Choices B, C, and D pose risks of contamination, bacterial growth, or air introduction.