“A nurse is obtaining a 2-hr postprandial blood glucose from a patient. Which of the following actions should the nurse take?”

“Hold the finger above the heart prior to puncture.”.

“Smear the blood onto the reagent strip.”.

“Puncture the finger while still damp with antiseptic solution.”.

“Select the lateral side of the finger for puncture.”.

Answer and Explanation

The Correct Answer is D

Choice A rationale
Holding the finger above the heart prior to puncture does not affect the accuracy of a blood glucose test.
Choice B rationale
Smearing the blood onto the reagent strip can result in inaccurate readings.
Choice C rationale
Puncturing the finger while still damp with antiseptic solution can cause discomfort and potentially contaminate the sample.
Choice D rationale
Selecting the lateral side of the finger for puncture is recommended because it is less painful and has good blood flow.

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Correct Answer is D

Explanation

Choice A rationale
Epigastric discomfort is not typically associated with pyelonephritis. It may be a symptom of other conditions such as gastrointestinal issues or preeclampsia.
Choice B rationale
Abdominal cramping is not a typical manifestation of pyelonephritis. It could be a symptom of various other conditions, including gastrointestinal disorders or gynecological issues.
Choice C rationale
A temperature of 37.2°C (99.8°F) is within the normal range and is not indicative of pyelonephritis. Pyelonephritis, an infection of the kidneys, is typically associated with a high fever.
Choice D rationale
Flank pain is a common manifestation of pyelonephritis. This is because the kidneys, which are affected in pyelonephritis, are located in the flank area.

A. Check the client’s serum medication level. B. Determine the client’s apical pulse rate. C. Ask the client if they are taking the medication as prescribed. D. Assess the client’s kidney function.

Correct Answer is A

Explanation

The correct answer is choice a. Check the client’s serum medication level.

Choice A rationale:

Checking the client’s serum medication level is the most direct and objective method to evaluate medication adherence. It provides a quantifiable measure of the digoxin level in the blood, indicating whether the client is taking the medication as prescribed.

Choice B rationale:

Determining the client’s apical pulse rate is important for monitoring the effects of digoxin, as it can affect heart rate. However, it does not directly measure medication adherence.

Choice C rationale:

Asking the client if they are taking the medication as prescribed relies on self-reporting, which can be inaccurate due to forgetfulness or intentional non-disclosure.

Choice D rationale:

Assessing the client’s kidney function is important for dosing and monitoring potential side effects of digoxin, but it does not directly evaluate medication adherence.

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“A nurse is obtaining a 2-hr postprandial blood glucose from a patient. Which of the following actions should the nurse take?”

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