1.1 . Question
The nurse should visit which of the following clients first?
o A. The client with diabetes with a blood glucose of 95 mg/dL
o B. The client with hypertension being maintained on Lisinopril
o C. The client with chest pain and a history of
angina o D. The client with Raynaud’s disease
Correct Answer: C. The client with chest pain and a history of angina
The client with chest pain should be seen first because this could indicate a
myocardial infarction. Despite many advances in treatment, acute MI still carries
a mortality rate of 5-30%; the majority of deaths occur prior to arrival to the
hospital. In addition, within the first year after an MI, there is an additional
mortality rate of 5% to 12%. The overall prognosis depends on the extent of
heart muscle damage and ejection fraction.
o Option A: The client in answer A has blood glucose within normal
limits. The diagnosis of T1DM is usually through a characteristic history
supported by elevated serum glucose levels (fasting glucose greater
than 126 mg/dL, random glucose over 200 mg/dL, or hemoglobin A1C
(HbA1c exceeding 6.5%) with or without antibodies to glutamic acid
decarboxylase ( GAD) and insulin. o Option B: The client in this option
is maintained on blood pressure medication. Pharmacological therapy
consists of angiotensin-converting enzyme inhibitors (ACEi),
angiotensin receptor blockers (ARBs), diuretics (usually thiazides),
calcium channel blockers (CCBs), and beta-blockers (BBs), which
are instituted taking into account age, race, and comorbidities
such as presence of renal dysfunction, LV dysfunction, heart
failure, and cerebrovascular disease. JNC-8, ACC, and ESC/ ESH
have their separate recommendations for pharmacological
management.
o Option D: The client in answer D is in no distress. In Raynaud
phenomenon, blood-flow restriction occurs during cold
temperatures and emotional stress. Specifically, in Raynaud
phenomenon, there is vasoconstriction of the digital arteries and
cutaneous arterioles.
2 . Question
A client with cystic fibrosis is taking pancreatic enzymes. The nurse should
administer this medication:
o A. Once per day in the morning o B. Three
times per day with meals o C. Once per day
at bedtime o D. Four times per day
Correct Answer: B. Three times per day with meals
Pancreatic enzymes should be given with meals for optimal effects. These
enzymes assist the body in digesting needed nutrients. Chronic, supportive
therapy for patients with CF includes regular pancreatic enzymes, fat-soluble
vitamins (A, D, E, K), mucolytics, bronchodilators, antibiotics, and
antiinflammatory agents.
o Option A: A new class of medications known
as CFTR modulator therapies is designed to
correct the dysfunction by improving
production, intracellular processing, or
function of the CFTR protein caused by the
mutated gene. Each medication is targeted
at a
specific dysfunction caused by a specific gene mutation.
o Option C: Individuals with CF are encouraged to consume a highfat diet with supplemental fat-soluble vitamins to compensate for
malabsorption.
Additionally, patients living with CF are encouraged to consume a
high-calorie diet to maintain a healthy weight and combat chronic
inflammation and frequent infections that are commonly
encountered.
o Option D: According to the Cystic Fibrosis Foundation, women
should consume 2500 to 3000 calories a day, while men should
consume 3000 to 3700 calories a day. Those living in hot climates
or who participate in activities that cause sweating are encouraged
to consume additional sodium in their diet.
- 3 . Question
Cataracts result in the opacity of the crystalline lens. Which of the following best
explains the functions of the lens?
o A. The lens controls stimulation of the retina. o B. The
lens orchestrates eye movement.
o C. The lens focuses light rays on the retina. o D. The lens
magnifies small objects.
Correct Answer: C. The lens focuses light rays on the retina.
The lens allows light to pass through the pupil and focus light on the retina. The
lens is a curved structure in the eye that bends light and focuses it for the retina
to help you see images clearly. The crystalline lens, a clear disk behind the iris, is
flexible and changes shape to help you see objects at varying distances.
o Option A: Retinal tissue is stimulated by light but also
responds to mechanical disturbances. Flashing lights
usually are caused by separation of the posterior vitreous.
As the vitreous gel separates from the retina, it stimulates
the retinal tissue mechanically, resulting
in the release of phosphenes and the sensation of light