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The nurse obtains a fingerstick blood glucose reading of 48 mg/dL for the client with type 1 DM. The client is to receive 6 units of regular and 10 units of NPH insulin now. Which is the nurse's best immediate intervention?
- A. Administer the insulin that is due now.
- B. Call the lab for a STAT serum glucose level.
- C. Have the client choose foods for a meal now.
- D. Provide juice with 15 grams of carbohydrates.
Correct Answer: D
Rationale: Hypoglycemia is treated with 15 to 20 g of a simple (fast-acting) carbohydrate, such as 4 to 6 oz of fruit juice or 8 oz of low-fat milk.
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The nurse is preparing to administer the following medications. Which medication should the nurse question administering?
- A. The thyroid hormone to the client who does not have a T3, T4 level.
- B. The regular insulin to the client with a blood glucose level of 210 mg/dL.
- C. The loop diuretic to the client with a potassium level of 3.3 mEq/L.
- D. The cardiac glycoside to the client who has a digoxin level of 1.4 mg/dL.
Correct Answer: A
Rationale: Administering thyroid hormone without T3/T4 levels risks overtreatment, as levels confirm hypothyroidism. Insulin, diuretics, and digoxin are appropriate based on data.
Which medication order should the nurse question in the client diagnosed with untreated hypothyroidism?
- A. Thyroid hormones.
- B. Oxygen.
- C. Sedatives.
- D. Laxatives.
Correct Answer: C
Rationale: Sedatives risk respiratory depression in untreated hypothyroidism due to slowed metabolism. Thyroid hormones, oxygen, and laxatives are appropriate.
The client is diagnosed with hypothyroidism. Which signs/symptoms should the nurse expect the client to exhibit?
- A. Complaints of extreme fatigue and hair loss.
- B. Exophthalmos and complaints of nervousness.
- C. Complaints of profuse sweating and flushed skin.
- D. Tetany and complaints of stiffness of the hands.
Correct Answer: A
Rationale: Hypothyroidism causes fatigue and hair loss due to slowed metabolism. Exophthalmos/nervousness (hyperthyroidism), sweating, and tetany are unrelated.
In which position should the client be maintained after the subtotal thyroidectomy?
- A. Supine
- B. Sims'
- C. Semi-Fowler's
- D. Recumbent
Correct Answer: C
Rationale: Semi-Fowler's position reduces swelling and promotes airway patency after thyroidectomy.
The concepts of nutrition and metabolism have been identified for the client. Which referral should the nurse include in the plan of care?
- A. Physical therapy.
- B. Social work.
- C. Speech therapy.
- D. Dietary.
Correct Answer: D
Rationale: A dietary referral addresses nutrition and metabolism, optimizing dietary management for conditions like diabetes. Other referrals are unrelated.