Tiêu đề RECALLS 7 (NP4) SC ✅

2 | Page fruity-smelling breath. She is tachypneic and confused. Labs reveal: Blood glucose: 310 mg/dL; pH: 7.28; Bicarbonate: 16 mEq/L; Ketones: positive. The physician diagnoses diabetic ketoacidosis (DKA) and orders IV fluids, insulin, and electrolyte monitoring. 11. Which clinical manifestation or laboratory finding is the nurse MOST likely to detect in this patient? A. Marked polyuria with concentrated, dark urine B. Rapid, deep respirations accompanied by a fruity odor breath C. Profound hypertension with bounding pulses D. Severe bradycardia with cold, clammy skin 12. Which instruction would be LEAST effective in helping Ms. Reyes avoid another episode of DKA? A. Check blood glucose and ketones regularly, especially during illness or stress B. Skip insulin doses when eating less or feeling nauseated C. Maintain a consistent meal and snack schedule while adjusting insulin as prescribed D. Stay well-hydrated and seek early medical advice if signs of hyperglycemia appear 13. Which combination of findings BEST demonstrates that Ms. Reyes’ DKA is resolving? A. Blood glucose decreasing toward normal, serum bicarbonate improving, and urine ketones negative B. Persistent hyperglycemia, urine output decreasing, and serum sodium rising C. Blood pH remaining below 7.3, potassium dropping, and patient still tachypneic D. Fruity breath persists, patient reports nausea, and glucose slightly lower than admission 14. A type 2 diabetic patient presents with extreme thirst, polyuria, and serum osmolarity of 320 mOsm/L, but no ketones in urine. What is the nurse’s priority concern? A. Risk of hypoglycemia B. Fluid volume deficit C. Metabolic acidosis D. Impaired skin integrity Situation: Nurse Glinda is assigned to Mr. Fiyero, a 68-year-old man with Parkinson’s disease. He is admitted to the hospital with shortness of breath, a productive cough, and low-grade fever. Chest X-ray shows areas of consolidation in both lower lobes. 15. Which set of assessment findings MOST strongly supports Fiyero’s Parkinson’s disease diagnosis? A. Resting tremor, shuffling gait, and bradykinesia B. Sudden jerky movements, exaggerated reflexes, and joint swelling C. Fatigue, generalized muscle weakness, and hypotension D. Rapid mood swings, confusion, and slurred speech 16. Mr. Fiyero is being discharged on a combination of carbidopa/levodopa (Sinemet). The nurse is reviewing his medication instructions and explaining the purpose of the drug combination. A. Carbidopa slows the breakdown of levodopa in the brain, allowing higher dopamine levels B. Levodopa prevents carbidopa from crossing the blood-brain barrier, reducing side effects C. Carbidopa inhibits peripheral metabolism of levodopa, increasing the amount that reaches the brain D. Levodopa enhances carbidopa absorption in the intestines, improving overall efficacy 17. Mr. Fiyero has been showing changes in his daily functioning. His daughter reports that he sometimes forgets appointments, struggles to make decisions, and seems slower when planning activities. Which cognitive change is most commonly associated with Parkinson’s disease? A. Mood swings and sudden emotional changes B. Persistent low mood and loss of interest C. Impairment in remembering recent events or learning new information D. Suspiciousness or irrational distrust of others 18. Which Parkinson’s-related symptoms most likely contributed to Mr. Fiyero’s current pulmonary findings? A. Rigid muscles leading to impaired airway clearance B. Bradykinesia causing reduced mobility and fluid retention C. Postural instability resulting in orthostatic hypotension D. Micrographia and facial masking affecting swallowing reflex 19. Fiyero is being discharged after stabilization of his symptoms. Nurse Glinda provides education to his wife about home management. Which statement by Fiyero’s wife BEST demonstrates comprehension of the discharge instructions? A. “He should stop taking his carbidopa/levodopa when he feels dizzy or nauseated.” B. “I need to make sure he takes his medication at the same time every day, even if he’s feeling better.” C. “He can skip his exercises on days when he has mild tremors D. “I will give him extra doses of his medication if he seems very stiff in the morning.” Situation: Nurse Bobbie is assigned to the Otorhinolaryngology department, where she provides care to patients with a variety of ear, nose, and throat disorders. 20. Nurse Bobbie is assessing Mr. CJ, a 68-year-old man who comes to the ENT clinic complaining of frequent misunderstandings during conversations and difficulty following TV programs. Which statement made by Mr. Delgado would MOST suggest that he is experiencing hearing impairment? A. “I feel dizzy every time I stand up quickly.” B. “I often ask my grandchildren to repeat what they said.” C. “I notice my ears feel full after swimming.” D. “I get sharp pains in my jaw when chewing hard foods.” 21. Nurse Bobbie plans to use an otoscope for the assessment. Which explanation MOST accurately describes why the nurse should hold the otoscope using a pencil-grip technique during the ear examination? A. It allows the nurse to apply more pressure and widen the ear canal for better visualization. B. It gives the nurse precise control while minimizing the risk of injuring the delicate ear canal. C. It ensures the light intensity is maximized for observing internal structures. D. It helps the nurse maintain a sterile field while inserting the otoscope. 22. During a school field trip to a local amusement park, a group of students is standing near a live music stage where the sound level reaches 85–90 dB. Which health effect is MOST likely to occur from exposure to this noise level? A. Temporary ringing in the ears and possible hearing fatigue B. Sudden permanent hearing loss after a single exposure C. Increased visual disturbances due to overstimulation D. Immediate onset of vertigo and loss of balance 23. Mr. Dela Cruz, a 62-year-old man, has been taking high- dose aspirin daily for chronic joint pain related to osteoarthritis. During his follow-up visit, he complains of persistent ringing in his ears and notices that conversations seem muffled. Which instruction should the nurse give to Mr. Dela Cruz regarding his current symptoms? A. “These symptoms are common with prolonged aspirin use; you should report them and discuss dose adjustment with your provider.” B. “This ringing in the ears is likely caused by aging and is unrelated to your medication; continue taking the same dose.” C. “You should immediately stop all medications to prevent permanent hearing loss without consulting your doctor.” D. “Hearing loss from arthritis medications is temporary, so no interventions are necessary.” 24. Ms. Santos, a 45-year-old music teacher, complains of gradual hearing difficulty in her right ear. The nurse performs a Weber test and discusses the results with the nurse practitioner. Which Weber test finding would suggest that Ms. Santos has sensorineural hearing loss in one ear? A. The tuning fork sound is louder in the unaffected ear.