Reading Comprehension Flashcards

A laboratory report reads: 'Serum potassium 2.9 mEq/L (Reference: 3.5–5.0 mEq/L). Patient is on digoxin 0.125 mg daily.' Why is this lab result particularly significant for this patient?

Answer: Hypokalemia increases the risk of digoxin toxicity and cardiac arrhythmias

Hypokalemia potentiates digoxin toxicity by increasing cardiac sensitivity to the drug, raising the risk of life-threatening arrhythmias.

A patient's chart states: 'Allergies: Penicillin — anaphylaxis.' The physician orders 'Cephalexin 500 mg PO QID.' Based on this information, what should the nurse do FIRST?

Answer: Contact the prescribing physician to clarify the order given the documented allergy

Cephalosporins share a beta-lactam ring with penicillin and carry a cross-reactivity risk; a documented anaphylaxis history requires clarification before administration.

A clinical guideline passage reads: 'In patients with suspected sepsis, the Sepsis-3 criteria define sepsis as life-threatening organ dysfunction caused by a dysregulated host response to infection. The Sequential Organ Failure Assessment (SOFA) score is used to quantify organ dysfunction.' Which set of findings would MOST suggest sepsis per this definition?

Answer: Suspected infection plus acute change in SOFA score of ≥2 points

Sepsis-3 criteria define sepsis as suspected infection plus acute SOFA score increase of ≥2 indicating organ dysfunction.

A patient education brochure about insulin states: 'Rapid-acting insulins (e.g., lispro, aspart) should be given 0–15 minutes before meals. Regular insulin should be given 30 minutes before meals. Long-acting insulins (e.g., glargine) are given once daily at the same time and have no peak.' A patient asks why their glargine is given at bedtime every day. What is the BEST explanation?

Answer: Once-daily dosing at a consistent time maintains steady basal insulin coverage without peaks

Glargine provides peakless, 24-hour basal coverage; consistent once-daily timing ensures stable blood glucose levels without pronounced peaks.

A nursing research article states: 'A randomized controlled trial (RCT) is considered the gold standard for evaluating clinical interventions. Unlike cohort studies, RCTs use random allocation to minimize selection bias and confounding variables.' A nurse is evaluating two studies: one RCT and one retrospective chart review on the same topic. Which provides stronger evidence for practice change?

Answer: The RCT because random allocation reduces bias and strengthens causal inference

RCTs are the gold standard for evaluating interventions because randomization minimizes confounding and selection bias, providing stronger causal evidence.

A shift handover report reads: 'Mr. Chen in Room 14 is post-op day 2 following bowel resection. He has a nasogastric tube to low intermittent suction, is NPO, and receiving TPN. His abdomen remains distended and he has not passed flatus.' What does 'not passed flatus' indicate in this context?

Answer: Postoperative ileus may be present as bowel motility has not returned

Absence of flatus after bowel resection suggests postoperative ileus — the bowel has not yet regained peristaltic function.

A consent form preamble reads: 'Informed consent requires that patients receive information in a language and format they understand, have the capacity to make decisions, and provide voluntary agreement free from coercion.' A patient who speaks limited English is presented a consent form for surgery by a surgeon in a hurry, with the family member translating. What is the PRIMARY concern?

Answer: Family translation may not be accurate and does not ensure patient understanding or voluntary consent

Family members may omit, alter, or distort information and may introduce pressure; a certified medical interpreter should be used to meet informed consent standards.