Correct Answer: A

Rationale: When a nurse administers an incorrect insulin dose, the immediate concern is the risk of hypoglycemia, especially since the insulin dose given was for a higher blood glucose level than the actual reading. Hypoglycemia can occur when blood glucose levels drop below 70 mg/dL. Symptoms of hypoglycemia include shakiness, sweating, confusion, and in severe cases, loss of consciousness. Monitoring the client for hypoglycemia allows the nurse to detect and treat it promptly, ensuring the client's safety. While completing an incident report is important for documenting the medication error and preventing future occurrences, it is not the immediate priority. The nurse's first responsibility is to ensure the client's safety by addressing the potential hypoglycemia. Once the client's condition is stable, the nurse can then complete the incident report. Administering 15 to 20 grams of carbohydrate is a treatment for hypoglycemia. However, this action should only be taken if the client is actually experiencing hypoglycemia. The nurse should first monitor the client's blood glucose levels to confirm hypoglycemia before administering carbohydrates. Notifying the nurse manager is important for accountability and to ensure that appropriate follow-up actions are taken. However, it is not the immediate priority. The nurse should first monitor the client for hypoglycemia and address any immediate health concerns before notifying the nurse manager.

Correct Answer: C

Rationale: Mucositis is an inflammation of the mucous membranes lining the digestive tract, which is commonly associated with chemotherapy and radiation therapy, not directly with opioid use. While it can be a concern for cancer patients, it is not a typical side effect of opioids. Bleeding is not a common side effect of opioid medications. While cancer patients may experience bleeding due to various reasons, including the cancer itself or treatment-related issues, opioids do not typically cause bleeding. Opioid-induced constipation (OI
C) is a common side effect of opioid medications due to their action on the gastrointestinal tract. Opioids reduce gastrointestinal motility, leading to constipation, which can progress to impaction if not managed properly. This is a manifestation that nurses should anticipate and manage proactively in clients taking opioid medications for pain management. Diarrhea is not typically associated with opioid use. In fact, opioids are more likely to cause constipation rather than diarrhea. Diarrhea may occur as a result of other treatments or conditions but is not a direct side effect of opioids.

Correct Answer: B,C,D,E

Rationale:
Choice A: Cold extremities are not a typical symptom associated with Paget's disease of the bone. This condition usually does not affect the temperature of the limbs directly.
Choice B: Skeletal pain is a common symptom in Paget's disease due to the abnormal bone remodeling process. The affected bones may become painful, especially in the pelvis, spine, skull, and long bones.
Choice C: Visual loss can occur if Paget's disease affects the skull, leading to increased pressure on the nerves associated with vision. This pressure can result in visual impairment or loss.
Choice D: Cranial enlargement is a possible finding in Paget's disease when the skull is involved. The abnormal bone growth can cause the skull to increase in size.
Choice E: An abnormal gait may develop if Paget's disease affects the legs, causing the bones to bow and leading to difficulty walking.

Correct Answer: B

Rationale: Urine specific gravity is a measure of urine concentration. The normal range is typically from 1.005 to 1.030. A specific gravity of 1.035 indicates very concentrated urine, which could be due to dehydration or other factors, but it is not specifically indicative of chronic glomerulonephritis. Serum creatinine is a waste product from the normal breakdown of muscle tissue. Normal levels are approximately 0.6 to 1.2 mg/dL for males. A level of 7 mg/dL is significantly elevated and can indicate severe kidney dysfunction, which is consistent with chronic glomerulonephritis. This condition can lead to a decreased ability of the kidneys to filter waste, causing an accumulation of creatinine in the blood. Creatinine clearance is a test that measures how well creatinine is removed from the blood by the kidneys. The normal range is about 95 to 120 mL/min. A clearance of 120 mL/min is within the normal range and would not typically be expected in a client with chronic glomerulonephritis, as this condition usually results in reduced kidney function. Blood urea nitrogen (BUN) is another waste product filtered by the kidneys. Normal BUN levels are between 7 and 20 mg/dL. A BUN of 15 mg/dL is within the normal range and does not necessarily indicate kidney dysfunction from chronic glomerulonephritis.

Correct Answer: C

Rationale: Postmenopausal bleeding is a hallmark symptom of endometrial cancer. Any vaginal bleeding that occurs after menopause should be evaluated by a healthcare provider, as it can be an early sign of endometrial cancer. Unilateral swelling on the posterior of the vulva is not typically associated with endometrial cancer. Extreme abdominal pain with intercourse is more related to conditions like endometriosis. Green, malodorous vaginal discharge suggests infection, not endometrial cancer.