Nokea
The client ate 45 g of carbohydrate (carb) with the dinner meal. The client is to receive 2 units of aspart insulin subcutaneously for each carb choice (CHO) eaten (1 carb choice = 15 g). Which syringe shows the correct amount of insulin that the nurse should administer?
- A. Illustration 1: 16 units
- B. Illustration 2: 29 units
- C. Illustration 3: 1 unit
- D. Illustration 4: 6 units
Correct Answer: D
Rationale: The client should receive 6 units of insulin. Eating 45 g of carbohydrates equals 3 CHOs. If the client is to receive 2 units of insulin for each CHO, the total amount of aspart insulin is 3 CHO times 2 units per CHO = 6 units.
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Which laboratory data indicate to the nurse the client’s pancreatitis is improving?
- A. The amylase and lipase serum levels are decreased.
- B. The white blood cell (WBC) count is decreased.
- C. The conjugated and unconjugated bilirubin levels are decreased.
- D. The blood urea nitrogen (BUN) serum level is decreased.
Correct Answer: A
Rationale: Acute pancreatitis is characterized by elevated serum amylase and lipase levels due to pancreatic inflammation. A decrease in these levels indicates reduced pancreatic injury and improvement in the condition. While a decreased WBC count may suggest resolving infection, it is less specific. Bilirubin levels are relevant for biliary obstruction, not pancreatitis improvement, and BUN reflects renal function, not pancreatic status.
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.
During change of shifts, a nurse discovers that a hospitalized client with diabetes received two doses of insulin. After notifying the physician, which nursing action is most appropriate?
- A. Completing an incident report
- B. Calling the intensive care unit (ICU)
- C. Performing frequent neurologic checks
- D. Monitoring the client's blood glucose level
Correct Answer: D
Rationale: Monitoring blood glucose is critical to detect and manage potential hypoglycemia from the double dose.
The nurse is planning the care of a client diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH). Which interventions should be implemented? Select all that apply.
- A. Restrict fluids per health-care provider order.
- B. Assess level of consciousness every two (2) hours.
- C. Provide an atmosphere of stimulation.
- D. Monitor urine and serum osmolality.
- E. Weigh the client every three (3) days.
Correct Answer: A,B,D
Rationale: Fluid restriction, frequent consciousness checks, and osmolality monitoring manage SIADH’s hyponatremia and fluid overload. Stimulation is inappropriate, and weighing every 3 days is too infrequent.
Which nursing intervention is essential for monitoring the client's condition?
- A. Measuring intake and output
- B. Muxying blood glucose levels
- C. Inserting a Foley catheter
- D. Sending urine samples to the laboratory
Correct Answer: A
Rationale: Monitoring intake and output is critical in diabetes insipidus to assess fluid balance and the severity of polyuria.