Nokea
A client is admitted to the hospital with recently diagnosed Type I diabetes mellitus and is to have fasting blood work drawn this morning. At 7:00 A.M., the lab has not arrived to draw the blood. The client's dose of regular insulin is scheduled for 7:30 A.M. What is the best action for the nurse to take?
- A. Give the insulin as ordered
- B. Withhold the insulin until the lab comes and the client will be eating within 15 to 30 minutes
- C. Withhold the insulin until the blood has been drawn and the client has eaten
- D. Do not administer insulin until the blood work has been drawn and the results have been called back to the unit
Correct Answer: C
Rationale: Withholding insulin until blood is drawn and the client has eaten prevents hypoglycemia during fasting blood work.
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To reduce or eliminate the symptoms that a client with functional hypoglycemia experiences, it is best for the nurse to recommend eating five or six small meals containing which nutrient?
- A. Simple sugars
- B. Complete proteins
- C. Complex carbohydrates
- D. Unsaturated fats
Correct Answer: C
Rationale: Complex carbohydrates provide a steady glucose release, preventing hypoglycemic episodes.
The nurse is teaching the client newly diagnosed with type 2 DM. Which information should the nurse emphasize in the session?
- A. Use the arm when self-administering insulin.
- B. Exercise for 30 minutes daily, preferably after a meal.
- C. Consume 30% of the daily calorie intake from protein foods.
- D. Eat a 30-gram carbohydrate snack prior to strenuous activity.
Correct Answer: B
Rationale: Exercise increases insulin receptor sites in the tissue and can have a direct effect on lowering blood glucose levels. Exercise contributes to weight loss, which also decreases insulin resistance.
Which assessment technique is most appropriate when checking for laryngeal nerve damage in a client who has had a thyroidectomy?
- A. Turning the client's head from side to side
- B. Occurifying the client's swallowing
- C. Looking for tracheal deviation
- D. Asking the client to say 'Ah'
Correct Answer: D
Rationale: Asking the client to say 'Ah' assesses vocal cord function, which can be affected by laryngeal nerve damage.
The nurse identified a concept of metabolism for a client diagnosed with diabetes mellitus type 2. Which interventions should the nurse include in the plan of care? Select all that apply.
- A. Teach the client to perform self glucose monitoring.
- B. Instruct the client about complications of high-glucose levels.
- C. Instruct the client to inspect the feet daily.
- D. Explain the need to carry a source of quick-acting proteins.
- E. Encourage the client to have regular eye exams.
Correct Answer: A,B,C,E
Rationale: Glucose monitoring, complication education, foot inspections, and eye exams manage type 2 diabetes and prevent complications. Quick-acting proteins are incorrect; carbohydrates treat hypoglycemia.
A client has a transsphenoidal hypophysectomy to remove a pituitary tumor. When the client returns to the nursing unit following surgery, the head of the bed is elevated 30 degrees. What is the primary purpose for placing the client in this position?
- A. To promote respiratory effort
- B. To reduce pressure on the sella turcica
- C. To prevent acidosis
- D. To promote oxygenation
Correct Answer: B
Rationale: Elevating the head 30 degrees reduces pressure on the sella turcica, minimizing the risk of cerebrospinal fluid leakage post-hypophysectomy.