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The nurse has reviewed the Provider Prescriptions at 1045.

Exhibits

Which of the following actions should the nurse perform first?

Apply dressing to the foot wound.

Administer regular insulin 4 units subcutaneously x 1 dose.

schedule an appointment with an ophthalmologist.

Consult an outpatient wound care specialist.

Answer and Explanation

The Correct Answer is B

Rationale for Correct Choice

Administer regular insulin 4 units subcutaneously x 1 dose: The client’s blood glucose is significantly elevated at 250 mg/dL and they are showing signs of hyperglycemia (polyuria, weight loss, nausea). Administering insulin addresses an immediate metabolic imbalance and helps prevent complications such as diabetic ketoacidosis.

Rationale for Incorrect Choices

Apply dressing to the foot wound: Although the wound requires care, it is not the most urgent issue. Delaying insulin administration in a hyperglycemic client with systemic symptoms could increase the risk of metabolic crisis. Wound care can follow stabilization.
Schedule an appointment with an ophthalmologist: While ophthalmologic evaluation is essential for clients with diabetes, this is a non-urgent referral and can be scheduled after acute needs like hyperglycemia and wound care are addressed.
Consult an outpatient wound care specialist: Coordinating specialized wound care is important for infection control and healing, but it is not time-sensitive. The priority is addressing the elevated blood glucose level first to stabilize the client's condition.

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Correct Answer is D

Explanation

A. Encourage frequent visits from friends: While social interaction can be beneficial, it’s important to consider the individual’s needs and preferences. Overstimulation from too many visitors can cause anxiety or confusion, which can worsen cognitive symptoms.

B. Keep the over-the-bed light on: This may be helpful in preventing falls or confusion at night. However, it’s essential to avoid excessive lighting as it can disrupt the circadian rhythm, potentially leading to sleep disturbances. A dim nightlight is more appropriate.

C. Apply restraints to the upper extremities: Restraints should not be used as a first-line approach. They can increase confusion, anxiety, and the risk of injury. Non-restrictive interventions, such as proper positioning and a calm environment, should be prioritized.

D. Play serene, soothing music: Soothing music can be a helpful intervention to reduce anxiety, agitation, and confusion in clients with dementia. Music has been shown to have a calming effect, which can help the client feel more relaxed and at ease.

A. Ensure the door to the client's room remains open. B. Wear sterile gloves during patient care. C. Wear a lead apron when providing client care. D. Place a dosimeter on the client's gown.

Correct Answer is C

Explanation

A. Ensure the door to the client's room remains open: The door should be kept closed to minimize exposure to radiation. Keeping the door open increases the risk of radiation exposure to others in the area.

B. Wear sterile gloves during patient care: Sterile gloves are not required for care during internal radiation therapy unless there is direct contact with bodily fluids or radioactive materials. Standard precautions are sufficient.

C. Wear a lead apron when providing client care: A lead apron is recommended for healthcare workers to protect themselves from radiation exposure during internal radiation therapy. The lead apron absorbs radiation and helps reduce the risk of harmful exposure.

D. Place a dosimeter on the client's gown: The dosimeter is typically worn by healthcare workers to measure radiation exposure, not the client. The client would not wear a dosimeter in this situation.

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The nurse has reviewed the Provider Prescriptions at 1045. Exhibits Which of the following actions should the nurse perform first?

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The nurse has reviewed the Provider Prescriptions at 1045.

Exhibits

Which of the following actions should the nurse perform first?