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1. The nurse is taking a health history from a 29-year-old pregnant patient at the first prenatal visit. The patient reports no personal history of diabetes but has a parent who is diabetic. Which action will the nurse plan to take first?
- A. Teach the patient about administering regular insulin.
- B. Schedule the patient for a fasting blood glucose level.
- C. Discuss an oral glucose tolerance test for the twenty-fourth week of pregnancy.
- D. Provide teaching about an increased risk for fetal problems with gestational diabetes.
Correct answer: B
Rationale: The correct answer is B. Given the family history of diabetes, the initial action the nurse should take is to schedule the patient for a fasting blood glucose level. This will help in assessing if the patient has developed gestational diabetes. Choice A is incorrect because teaching about administering regular insulin is premature without confirming the diagnosis. Choice C is incorrect as an oral glucose tolerance test is typically done earlier in pregnancy. Choice D is incorrect as discussing fetal problems related to gestational diabetes should come after a confirmed diagnosis.
2. A nurse has just inserted a nasogastric (NG) tube for a client. Which of the following findings should the nurse expect to confirm correct tube placement?
- A. The client reports relief of nausea.
- B. The tube aspirate has a pH less than 5.
- C. Bowel sounds are present on auscultation.
- D. An x-ray shows the end of the tube above the pylorus.
Correct answer: A
Rationale: The correct answer is A: The client reports relief of nausea. When the NG tube is correctly placed in the stomach, it can help alleviate feelings of nausea and discomfort. Choice B, a tube aspirate pH less than 5, is incorrect as it indicates gastric placement, not necessarily correct placement. Choice C, bowel sounds on auscultation, and Choice D, visualization of the tube on an x-ray above the pylorus, do not confirm correct NG tube placement; therefore, they are incorrect.
3. A 28-year-old male patient with type 1 diabetes reports how he manages his exercise and glucose control. Which behavior indicates that the nurse should implement additional teaching?
- A. The patient always carries hard candies when engaging in exercise.
- B. The patient goes for a vigorous walk when his glucose is 200 mg/dL.
- C. The patient has a peanut butter sandwich before going for a bicycle ride.
- D. The patient increases daily exercise when ketones are present in the urine.
Correct answer: D
Rationale: The correct answer is D because increasing exercise when ketones are present in the urine is inappropriate and potentially dangerous for a patient with type 1 diabetes. This behavior can worsen the ketosis and lead to further complications. Choices A, B, and C demonstrate appropriate self-management strategies for a patient with type 1 diabetes. Carrying hard candies during exercise can help prevent hypoglycemia, going for a walk with a glucose level of 200 mg/dL can help lower blood sugar, and having a snack before physical activity can provide necessary energy.
4. Which of the following best describes the ethical concept of values?
- A. Values are an individual�s feelings about situations.
- B. Values are learned through family systems.
- C. Values are organized ways of thinking about the meaning of life.
- D. Values determine the rightness or wrongness of behavior.
Correct answer: C
Rationale: Values are organized ways of thinking about the meaning of life.
5. Under which category does a violation of the nurse practice act fall?
- A. Juvenile offenses
- B. Felonies
- C. Misdemeanors
- D. Torts
Correct answer: D
Rationale: A violation of the nurse practice act falls under the category of tort. Tort refers to civil wrongs that cause harm or loss to another person, and a violation of the nurse practice act can result in a civil lawsuit against the nurse for negligence or malpractice. Choices A, B, and C are incorrect because a violation of the nurse practice act does not fall under juvenile offenses, felonies, or misdemeanors, but rather under civil wrongs known as torts.
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