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1. A patient with type 1 diabetes is prescribed insulin glargine. What is the primary characteristic of this insulin?
- A. Rapid-acting
- B. Intermediate-acting
- C. Long-acting
- D. Short-acting
Correct answer: C
Rationale: Insulin glargine is classified as a long-acting insulin. It is designed to provide a consistent level of insulin over approximately 24 hours, helping to keep blood glucose levels stable throughout the day. This long duration of action makes it suitable for basal insulin replacement in patients with type 1 diabetes, providing a background level of insulin to mimic the body's natural release of insulin between meals and overnight.
2. A client with hyperthyroidism is prescribed propylthiouracil (PTU). Which instruction should the nurse include in the client's discharge teaching?
- A. Report any signs of infection, such as sore throat or fever, to your healthcare provider.'
- B. Increase your intake of iodine-rich foods, such as seafood and dairy products.'
- C. Take the medication on an empty stomach for better absorption.'
- D. You may experience weight gain and fatigue as side effects of the medication.'
Correct answer: A
Rationale: Propylthiouracil (PTU) can suppress bone marrow function, increasing the risk of infection, so it is important to report signs of infection promptly.
3. The healthcare provider is assessing a client with chronic obstructive pulmonary disease (COPD). Which finding should the provider expect?
- A. Increased anteroposterior chest diameter.
- B. Decreased respiratory rate.
- C. Dull percussion sounds over the lungs.
- D. Hyperresonance on chest percussion.
Correct answer: A
Rationale: The correct answer is A: Increased anteroposterior chest diameter. The increased anteroposterior chest diameter, often referred to as a barrel chest, is a common finding in clients with COPD due to hyperinflation of the lungs. This occurs because of the loss of lung elasticity and air trapping, leading to a more rounded chest shape. Choices B, C, and D are incorrect. Decreased respiratory rate is not typically associated with COPD; instead, an increased respiratory rate may be seen due to the body's compensatory mechanisms. Dull percussion sounds and hyperresonance on chest percussion are not characteristic findings in COPD. Dull percussion sounds may be indicative of consolidation or pleural effusion, while hyperresonance is more commonly associated with conditions like emphysema.
4. A client with heart failure is prescribed furosemide (Lasix). Which instruction should the nurse include in the client's teaching plan?
- A. Take the medication before bedtime.
- B. Report any weight gain of more than 2 pounds in a day.
- C. Increase your intake of high-sodium foods.
- D. Limit your fluid intake to less than 1 liter per day.
Correct answer: B
Rationale: In heart failure, fluid retention is a concern. Furosemide helps manage this by promoting diuresis. Instructing the client to report weight gain exceeding 2 pounds in a day is crucial as it can indicate fluid accumulation, prompting timely intervention to prevent worsening heart failure symptoms and complications.
5. A 70-year-old woman presents with fatigue, anorexia, and weight loss. She has noticed darkening of her skin, particularly in sun-exposed areas. Laboratory tests reveal hyponatremia, hyperkalemia, and low cortisol levels. What is the most likely diagnosis?
- A. Cushing's syndrome
- B. Addison's disease
- C. Hypothyroidism
- D. Pheochromocytoma
Correct answer: B
Rationale: The combination of symptoms such as fatigue, anorexia, weight loss, hyperpigmentation of the skin, along with hyponatremia, hyperkalemia, and low cortisol levels, points towards Addison's disease. This condition is characterized by adrenal insufficiency, leading to a deficiency in cortisol and aldosterone production.
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