Robert, a 57-year-old client with acute arterial occlusion of the left leg undergoes an emergency embolectomy. Six hours later, the nurse isn't able to obtain pulses in his left foot using Doppler ultrasound. The nurse immediately notifies the physician, and asks her to prepare the client for surgery. As the nurse enters the client's room to prepare him, he states that he won't have any more surgery. Which of the following is the best initial response by the nurse?

Correct Answer: A

Rationale: The correct initial response by the nurse in this scenario is A: Explain the risks of not having the surgery. This is the best initial response because the nurse needs to ensure the client fully understands the consequences of refusing the surgery. By explaining the risks, the nurse can provide the client with necessary information to make an informed decision about their healthcare. Notifying the physician immediately (choice B) is important, but the immediate concern is addressing the client's refusal. Notifying the nursing supervisor (choice C) is not as crucial as addressing the client directly. Recording the client's refusal in the nurses' notes (choice D) should be done after addressing the client's concerns and providing necessary information.

Correct Answer: B

Rationale: To determine the ml/hr rate, divide the total units in the bag by the ordered rate in units/hour. 25,000 units ÷ 1,500 units/hour = 16.67 ml/hour. This rounds to 17 ml/hour, which is closest to choice B (30 ml/hour). Choices A, C, and D are incorrect as they are not the closest to the calculated rate of 17 ml/hour.

Correct Answer: A

Rationale: Correct Answer: A (Hyperkalemia) Rationale: In acute addisonian crisis, the adrenal glands fail to produce adequate cortisol and aldosterone, leading to decreased sodium and increased potassium levels. Hyperkalemia is a common finding due to aldosterone deficiency causing impaired potassium excretion. The elevated potassium levels can result in life-threatening cardiac arrhythmias. Summary: B: Reduced BUN - Not typically associated with acute addisonian crisis. C: Hypernatremia - Uncommon in addisonian crisis due to aldosterone deficiency. D: Hyperglycemia - Can occur in addisonian crisis but is not as specific as hyperkalemia.

Correct Answer: C

Rationale: The correct answer is C. When a patient has AIDS, it is crucial to avoid sharing personal items like toothbrushes and razors to prevent the transmission of infections. This is because these items can potentially transfer blood or bodily fluids, increasing the risk of spreading infections or diseases. By instructing the patient to avoid sharing such articles, the nurse is promoting infection control and protecting both the patient and others from potential harm. Choice A is incorrect because wearing disposable gloves before bathing is unnecessary unless there are open wounds or skin lesions that need to be protected. Choice B is incorrect as sterilizing plates and utensils in boiling water is not a necessary precaution for someone with AIDS. Choice D is incorrect as avoiding eating foods from shared serving dishes is not as critical as avoiding sharing personal items that have direct contact with bodily fluids.

Correct Answer: D

Rationale: Step-by-step rationale: 1. Strawberries are a common allergen due to the presence of proteins that can trigger allergic reactions. 2. Allergies to strawberries are relatively common, especially in females. 3. Nurse Len should be cautious when inquiring about strawberry consumption to prevent potential allergic reactions. 4. Bread, carrots, and oranges are not as commonly associated with allergies compared to strawberries. Summary: Strawberries are a common allergen due to specific proteins, making them a priority for Nurse Len to consider during a dietary history. Bread, carrots, and oranges are less likely to cause allergic reactions compared to strawberries.