- (Topic 5)
At her monthly prenatal visit, a client reports experiencing heartburn. Which nursing measure should be included in her plan of care to help alleviate it?

1. A. Restrict fluid intake.
2. B. Use Alka-Seltzer as necessary.
3. C. Eat small, frequent bland meals.
4. D. Lie down after eating.

Correct Answer: C
(A) At least eight glasses of fluid per day are encouraged to help dilute stomach contents, thereby decreasing irritation. (B) Alka Seltzer contains aspirin, which is irritating to gastric mucosa, and therefore should be avoided. (C) Small, frequent bland meals help to decrease gastric pressure and to prevent reflux. (D) Lying down after meals may cause gastric reflux and prevents optimal gastric emptying.

- (Topic 4)
One week ago, a 21-year-old client with a diagnosis of bipolar disorder was started on lithium 300 mg po qid. A lithium level is ordered. The client??s level is 1.3 mEq/L. The nurse recognizes that this level is considered to be:

1. A. Within therapeutic range
2. B. Below therapeutic range
3. C. Above therapeutic range
4. D. At a level of toxic poisoning

Correct Answer: A
(A) This answer is correct. The therapeutic range is 1.0–1.5 mEq/L in the acute phase. Maintenance control levels are 0.6–1.2 mEq/L. (B, C) This answer is incorrect. A level of 1.3 mEq/L is within therapeutic range. (D) This answer is incorrect. Toxic poisoning is usually at the 2.0 level or higher.

- (Topic 4)
A client is admitted to the hospital with diabetic ketoacidosis.
The emergency room nurse should anticipate the administration of:

1. A. Humulin N
2. B. Humulin R
3. C. Humulin U
4. D. Humulin L

Correct Answer: B
(A) Intermediate-acting insulin is not indicated in an emergency. (B) Regular insulin is rapid acting and indicated in an emergency situation. (C) Long-acting insulin is not indicated in an emergency situation. (D) Intermediate-acting insulin is not indicated in an emergency situation.

- (Topic 5)
A male client is admitted to the psychiatric unit after experiencing severe depression. He states that he intends to kill himself, but he asks the nurse not to repeat his intentions to other staff members. Which response demonstrates understanding and appropriate action on the part of the nurse?

1. A. ??I understand you??re depressed, but killing yourself is not a reasonable option.??
2. B. ??We need to discuss this further, but right now let??s complete these forms.??
3. C. ??Don??t do that, you have so much to live fo
4. D. You have a wonderful wife and childre
5. E. The client in the next room has no one.??
6. F. ??This is very seriou
7. G. I do not want any harm to come to yo
8. H. I will have to report this to the rest of the staff.??

Correct Answer: D
(A) To the client, suicide may be a reasonable action and the only one he can cope with at this time. (B) This response indicates to the client that his intention to commit suicide is not important to the nurse at this time. (C) The client is so depressed that he is not able to see the positive aspects of his life. At no time should the nurse discuss another client??s problems in conversation. (D) This statement tells the client that the nurse recognizes his problem is of a serious nature and will take all steps necessary to help him.

- (Topic 7)
Diabetes mellitus is a disorder that affects 3.1 out of every 1000 children younger than 20 years old. It is characterized by an absence of, or marked decrease in, circulating insulin. When teaching a newly diagnosed diabetes client, the nurse includes information on the functions of insulin:

1. A. Transport of glucose into body cells and storage of glycogen in the liver
2. B. Glycogenolysis and facilitation of glucose use for energy
3. C. Glycogenolysis and catabolism
4. D. Catabolism and hyperglycemia

Correct Answer: A
(A) Lack of insulin causes glycogenolysis, catabolism, and hyperglycemia. (B) Insulin promotes the conversion of glucose to glycogen for storage and regulates the rate at which carbohydrates are used by cells for energy. (C) Insulin is anabolic in nature. (D) Glucose stimulates protein synthesis within the tissue and inhibits the breakdown of protein into amino acids.