A client comes into the emergency room with complaints of an enlarged tongue. The tongue appears smooth and beefy red in color. The nurse also observes a 5-cm incision on the upper left quadrant of the abdomen. When questioned, the patient states, "I had a partial gastrostomy 2 years ago." Based on this information, the nurse attributes these symptoms to which of the following problems?

Vitamin A deficiency

Folic acid deficiency

Vitamin B12 deficiency

Vitamin C deficiency

Answer and Explanation

The Correct Answer is C

A. Vitamin A Deficiency:
Symptoms: Enlarged tongue and smooth, beefy red appearance.
Relevance: Vitamin A deficiency is not typically associated with an enlarged tongue. It is more commonly linked to night blindness and skin issues.

B. Folic Acid Deficiency:
Symptoms: Enlarged tongue and smooth, beefy red appearance.
Relevance: Folic acid deficiency can lead to megaloblastic anemia and glossitis (inflammation of the tongue), which may present as an enlarged, smooth, and red tongue.

C. Vitamin B12 Deficiency:
Symptoms: Enlarged tongue and smooth, beefy red appearance.
Relevance: Vitamin B12 deficiency can cause pernicious anemia and glossitis, resulting in an enlarged, smooth, and red tongue.

D. Vitamin C Deficiency:
Symptoms: Not typically associated with an enlarged tongue.
Relevance: Vitamin C deficiency is more commonly associated with symptoms like scurvy, which includes bleeding gums, joint pain, and skin issues, but not specifically an enlarged tongue.

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Correct Answer is C

Explanation

A. "I can eat a salad with oil and vinegar dressing":
Explanation: This statement is correct. A salad with oil and vinegar dressing is a healthy option, and the patient does not need to avoid this.

B. "I can cook soup using canned vegetables":
Explanation: This statement is generally acceptable. However, the patient should be aware of the sodium content in canned vegetables and choose low-sodium options to manage fluid retention, which can be a concern in Cushing's syndrome.

C. "I can eat dried fruit for breakfast with my oatmeal":
Explanation: This statement is questionable. Dried fruits may have higher sugar content and can contribute to an increase in calorie intake. In Cushing's syndrome, where there may be weight gain, it's advisable to choose fresh fruits over dried ones.

D. "I can eat baked chicken with green beans for dinner":
Explanation: This statement is correct. Baked chicken with green beans is a healthy and balanced option.

A. I will inject my insulin by pinching up a large area of skin, and then inserting the needle. B. I can mix my regular acting insulin and my Lantus in the same syringe. C. I can inject my insulin in the same location each time. D. I can use a needle/syringe more than once since I am the only one using it. E. I will discard my used syringes in a hard container, like an empty plastic milk jug.

Correct Answer is ["A","B"]

Explanation

A. I will inject my insulin by pinching up a large area of skin, and then inserting the needle.
The correct technique for subcutaneous insulin injection involves pinching a small area of skin (creating a skinfold) and inserting the needle at a 90-degree angle. Injecting into a large area might result in inadequate subcutaneous administration.

B. I can mix my regular acting insulin and my Lantus in the same syringe.
Lantus (insulin glargine) is a long-acting insulin that should not be mixed with other insulins. It should be administered separately to maintain its long-acting profile.

C. I can inject my insulin in the same location each time.
This statement is correct. Injecting insulin into the same general area consistently can help with consistent absorption.

D. I can use a needle/syringe more than once since I am the only one using it.
It is not safe to reuse needles or syringes. Single-use needles and syringes should be disposed of properly after each use to prevent infection and other complications.

E. I will discard my used syringes in a hard container, like an empty plastic milk jug.
This statement is correct. Used syringes should be discarded in a puncture-resistant container, and an empty plastic milk jug can serve as a suitable container for disposal.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client with Cushing's syndrome is receiving education about dietary changes from the nurse. Which statement by the patient demonstrates the need for further teaching?

Correct Answer is C

Explanation

The nurse instructs the client about the self-administration of insulin. Which statement or statements by the patient indicate a need for further teaching? (SELECT ALL THAT APPLY)

Correct Answer is ["A","B"]

Explanation

A client comes into the clinic complaining of fatigue. Blood work shows an increased bilirubin concentration and an increased reticulocyte count. What would the nurse suspect the patient has?

A patient has the following blood gases: PaCO2 33, pH 7.50, HCO3 23. Which of the following could NOT be the cause of this condition?

A nursing instructor is evaluating a student caring for a neutropenic client. The instructor concludes that the nursing student demonstrates accurate knowledge of neutropenia based on which of the following interventions?

The nurse is caring for a patient with Addison's disease who is scheduled for discharge. When teaching the patient about hormone replacement therapy, the nurse should address what topic?

A client with diabetes mellitus is ordered to receive insulin for glucose correction (sliding scale coverage). The nurse knows the rapid acting insulin Insulin Lispro (Humalog) onset and peak action time are:

A nurse reviews the arterial blood gas (ABG) values of a client admitted with pneumonia: pH, 7.32; PaCO2, 48 mm Hg; PaO2, 70 mm Hg; and HCO3, 24 mEq/L. What do these values indicate?

A nurse is providing education to a client with iron deficiency anemia who has been prescribed iron supplements. What should the nurse include in health education?