You enter the room of your known diabetic patient and find them unresponsive. After ensuring they are breathing and have a patent airway, you check a blood glucose and find it to be 30 mg/dL. Which of the following medications should be the priority to administer?

15-30g oral carbohydrates.

10% dextrose continuous IV infusion

Glucagon PO,

50% dextrose in water (050W) IV push

Answer and Explanation

The Correct Answer is D

A. 15-30g oral carbohydrates:
Oral carbohydrates are a first-line treatment for hypoglycemia in a conscious, alert patient who can safely swallow. However, since the patient is unresponsive, administering oral carbohydrates is not an appropriate option. The patient’s inability to swallow safely increases the risk of aspiration, making IV treatment the priority in this case.

B. 10% dextrose continuous IV infusion:
A 10% dextrose IV infusion can be used in the management of hypoglycemia, but in an acute, emergency setting where the patient is unresponsive and their blood glucose is critically low (30 mg/dL), a rapid-acting intervention is needed. A bolus dose of a concentrated solution, such as 50% dextrose, is more appropriate for quickly raising the blood glucose level in this situation, rather than a continuous infusion, which takes longer to achieve an effective increase in glucose.

C. Glucagon PO:
Glucagon is typically used for hypoglycemia in patients who are unconscious or unable to take oral glucose. However, glucagon is typically administered intramuscularly (IM) or subcutaneously (SQ), not orally (PO). Administering glucagon orally is ineffective, as it would not be absorbed by the body in the necessary manner to correct hypoglycemia. Therefore, this option is inappropriate.

D. 50% dextrose in water (50% DW) IV push:
When a patient is unresponsive and their blood glucose level is critically low (30 mg/dL), the priority treatment is an immediate, concentrated source of glucose. Administering 50% dextrose IV push is the most appropriate intervention in this scenario. It provides a rapid and effective increase in blood glucose levels, which is critical for reversing hypoglycemia in an emergency situation. This is the fastest and most direct approach to treating severe hypoglycemia in an unresponsive patient.

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Correct Answer is A

Explanation

A) Wear a HEPA/N95 mask while providing care to the client:
Tuberculosis (TB) is a highly contagious airborne disease, and healthcare workers caring for patients with active TB must wear a HEPA/N95 mask to protect themselves from inhaling the bacteria. These specialized masks filter out airborne particles, including Mycobacterium tuberculosis, which can be spread through droplets when the patient coughs, sneezes, or talks. Wearing an N95 mask is an essential part of airborne precautions in the care of TB patients.

B) Instruct the nursing assistant to wear a surgical mask when entering the client's room:
A surgical mask does not offer adequate protection against airborne pathogens like the tuberculosis bacteria. While surgical masks can block large droplets, they do not filter out smaller, airborne particles, such as those from TB. N95/HEPA masks are necessary for anyone entering the room of a patient with active tuberculosis, including nursing assistants, to ensure they are protected from inhaling infectious particles.

C) Ensure the client is in a positive pressure room:
A positive pressure room is typically used for patients who are immunocompromised, such as those with neutropenia or undergoing organ transplants, to prevent infection from the environment. However, negative pressure rooms are required for patients with airborne diseases like tuberculosis. A negative pressure room ensures that air flows into the room but does not leave, containing any airborne pathogens and preventing their spread to other areas of the facility.

D) Have the client wear a HEPA/N95 mask when outside of their room:
If the client with active tuberculosis needs to leave their room for medical procedures or testing, they should wear a HEPA/N95 mask to prevent spreading the bacteria to others through airborne transmission. This helps limit exposure to other individuals, as TB can be transmitted by airborne particles.

A. Pernicious anemia B. Blood loss anemia C. Sickle cell anemia D. Aplastic anemia

Correct Answer is B

Explanation

A. Pernicious anemia:
Pernicious anemia is primarily caused by a deficiency in vitamin B12, often due to a lack of intrinsic factor needed for absorption in the gut. It typically presents with symptoms like weakness, fatigue, and neurological manifestations such as numbness or tingling. However, the client’s presentation does not suggest a vitamin B12 deficiency or neurological signs. Additionally, pernicious anemia is not typically associated with heavy menstrual periods,
which are more indicative of blood loss anemia.

B. Blood loss anemia:
Blood loss anemia is the most likely diagnosis in this case, especially in the context of heavy menstrual periods, which can cause significant blood loss over time. The client’s hemoglobin level of 6.9 g/dL indicates severe anemia, which is consistent with the cumulative effects of chronic blood loss. This type of anemia results from a decrease in red blood cell count due to bleeding, which can lead to symptoms like weakness, fatigue, and pallor.

C. Sickle cell anemia:
Sickle cell anemia is a genetic condition characterized by abnormally shaped red blood cells, which can lead to hemolysis and episodes of pain. While it can cause symptoms like fatigue and weakness, sickle cell anemia typically presents earlier in life and is more associated with episodes of severe pain and organ damage. Additionally, the patient’s history does not mention episodes of pain or other hallmark signs of sickle cell disease, such as swelling in the hands or feet or recurrent infections.

D. Aplastic anemia:
Aplastic anemia occurs when the bone marrow fails to produce enough blood cells, including red blood cells, white blood cells, and platelets. It presents with symptoms like weakness, fatigue, frequent infections, and bruising. Although this client does have anemia, the lack of additional signs (such as petechiae, infections, or bleeding) makes this diagnosis less likely. Aplastic anemia is also usually diagnosed with bone marrow biopsy, which is not suggested by this client's presentation.

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You enter the room of your known diabetic patient and find them unresponsive. After ensuring they are breathing and have a patent airway, you check a blood glucose and find it to be 30 mg/dL. Which of the following medications should be the priority to administer?

Nursing Test Bank

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Correct Answer is A

Explanation

A nurse is caring for a young female adult client who reports weakness, fatigue, and heavy menstrual periods. The client has a hemoglobin level of 6.9 g/dL. The nurse suspects which of the following types of anemia?

Correct Answer is B

Explanation

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