The nurse provides sliding scale insulin administration instructions to an adult who was recently diagnosed with diabetes mellitus. The client demonstrates an understanding of the instructions provided by performing the procedure in which order? (Arrange with the first on top and the last on the bottom.)

Obtain blood glucose level.

Verify the insulin prescription.

Draw insulin into insulin syringe.

Cleanse the selected site.

Answer and Explanation

The Correct Answer is B,A,D,C

1. B. Verify the insulin prescription: The first step is to verify the prescription to ensure the correct type and dose of insulin before administering it. This ensures one is following the appropriate instructions.

2. A. Obtain blood glucose level: The next step is to check the client's blood glucose level to determine the amount of insulin needed based on the sliding scale.

3. D. Cleanse the selected site: After obtaining the blood glucose level, the next step is to prepare the injection site by cleaning it properly to prevent infection.

4. C. Draw insulin into insulin syringe: Finally, drawing the appropriate amount of insulin into the syringe, based on the sliding scale and the blood glucose level, to administer the injection.

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Naxlex Comprehensive Predictor Exams

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Correct Answer is A

Explanation

A. Demonstrate to the PN how to position the client more effectively for the procedure:
The correct position for a sigmoidoscopy is the left lateral or Sims' position to allow easier access to the sigmoid colon. Demonstrating the correct position supports patient safety and provides teaching for the PN.

B. Arrange for unlicensed assistive personnel to assist the PN during the procedure: Assistance is not the issue in this scenario; the problem lies in incorrect positioning. Assigning additional help does not address the need to correct the client's position.

C. Acknowledge that the PN has positioned the client safely and correctly: The flat prone position is not appropriate for a sigmoidoscopy. Acknowledging incorrect positioning would be unsafe and potentially delay the procedure or increase the risk of injury.

D. Assume care of the client and assign the PN to the care of a different client: This is an excessive response that undermines the PN’s role. The more constructive approach is to guide and support the PN through demonstration rather than reassignment.

A. "Risk for self-directed violence as evidenced by feelings of hopelessness." B. "Chronic low self-esteem as evidenced by feelings of worthlessness." C. "Anxiety as evidenced by abdominal discomfort secondary to depression." D. "Imbalanced nutrition as evidenced by 25 lb (11 kg) weight loss in four months."

Correct Answer is A

Explanation

A. "Risk for self-directed violence as evidenced by feelings of hopelessness": The client’s feelings of hopelessness, combined with significant weight loss and loss of interest in activities, suggest possible depression. Hopelessness is a key symptom of depression, which can increase the risk for self-harm or suicide.

B. "Chronic low self-esteem as evidenced by feelings of worthlessness": Feelings of worthlessness are part of the larger picture of the client’s depression. The priority is to address the immediate risk of harm, which takes precedence over chronic low self-esteem.

C. "Anxiety as evidenced by abdominal discomfort secondary to depression": While abdominal discomfort can be a symptom of depression, it is secondary to the more immediate concern of the client’s potential risk for self-directed violence.

D. "Imbalanced nutrition as evidenced by 25 lb (11 kg) weight loss in four months": The significant weight loss is concerning, but it is likely a result of the client’s depression. The focus should first be on addressing the client’s safety, followed by nutrition and weight restoration.

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Naxlex Comprehensive Predictor Exams

The nurse is setting up the equipment to assist with a sigmoidoscopy while the practical nurse (PN) positions the client in a flat prone position. Which action should the nurse implement?

Correct Answer is A

Explanation

Correct Answer is A

Explanation

Before leaving the room of a client who is confused, the nurse observes that a half bow knot was used to attach the client's wrist restraints to the movable portion of the client's bed frame. Which action should the nurse take before leaving the room?

The nurse is preparing to obtain a rapid coronavirus (COVID-19) test for a client who was exposed to the virus eight days ago. The client is experiencing fever, cough, and shortness of breath. Which action is most important for the nurse to take?

Exhibits For each assessment finding, click to indicate whether the findings from the client's assessment are generally associated with rotator cuff injury and/or humeral fracture. Each column must have at least one response selected.

The wife of a newly diagnosed client with Parkinson's disease asks the nurse if alternative or complimentary medical therapies might cure the disease. Which response should the nurse provide?

The nurse is caring for a client with the sexually transmitted infection (STI) syphilis. The client reports having sex with someone who had many partners. Which response should the nurse provide?