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A client is being educated about type 2 diabetes. The educator can confirm that the client understands the primary treatment for type 2 diabetes when the client states what?
- A. I read that a pancreas transplant will provide a cure for my diabetes.
- B. I will take my oral antidiabetic agents when my morning blood sugar is high.
- C. I will make sure to follow the weight loss plan designed by the dietitian.
- D. I will make sure I call the diabetes educator when I have questions about my insulin.
Correct Answer: C
Rationale: Correct Answer: C
Rationale:
1. Weight loss helps improve insulin sensitivity.
2. Managing weight is crucial for controlling blood sugar levels.
3. Dietitian-designed plans focus on balanced nutrition for diabetes management.
4. Weight loss can reduce the need for medication and improve overall health.
Summary of Incorrect Choices:
A: Pancreas transplant is not a primary treatment for type 2 diabetes.
B: Taking oral antidiabetic agents based on blood sugar levels is not ideal.
D: Contacting the diabetes educator for insulin questions is important but not primary treatment.
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A client with a history of deep vein thrombosis (DVT) is receiving warfarin (Coumadin). Which laboratory value indicates a therapeutic effect of the medication?
- A. INR of 2.5.
- B. PTT of 45 seconds.
- C. Hemoglobin of 12 g/dL.
- D. Platelet count of 150,000/mm³.
Correct Answer: A
Rationale: The correct answer is A: INR of 2.5. INR (International Normalized Ratio) is used to monitor the effectiveness of warfarin therapy. A target INR range for DVT treatment is typically 2.0-3.0. An INR of 2.5 indicates that the client's blood is clotting within the desired therapeutic range, preventing excessive clotting while avoiding excessive bleeding.
B: PTT measures the effectiveness of heparin, not warfarin.
C: Hemoglobin level and D: Platelet count are not specific indicators of warfarin's therapeutic effect on clotting factors.
In summary, the correct answer A is the most relevant laboratory value for monitoring the therapeutic effect of warfarin in a client with DVT.
A 28-year-old woman presents with abdominal pain, bloating, and diarrhea. She notes that her symptoms improve with fasting. She has a history of iron deficiency anemia. What is the most likely diagnosis?
- A. Irritable bowel syndrome
- B. Celiac disease
- C. Lactose intolerance
- D. Crohn's disease
Correct Answer: B
Rationale: The most likely diagnosis is Celiac disease (Choice B) due to the patient's symptoms of abdominal pain, bloating, diarrhea, and improvement with fasting, which are consistent with malabsorption seen in Celiac disease. The history of iron deficiency anemia also supports this, as it is a common complication of Celiac disease due to impaired absorption of nutrients. Irritable bowel syndrome (Choice A) typically does not improve with fasting, lactose intolerance (Choice C) does not usually cause iron deficiency anemia, and Crohn's disease (Choice D) typically presents with more severe symptoms and different patterns of improvement.
A 70-year-old man presents with weight loss, jaundice, and a palpable mass in the right upper quadrant. Laboratory tests reveal elevated bilirubin and alkaline phosphatase levels. What is the most likely diagnosis?
- A. Gallstones
- B. Hepatitis
- C. Pancreatic cancer
- D. Primary biliary cirrhosis
Correct Answer: C
Rationale: The most likely diagnosis in this case is pancreatic cancer (Choice C) based on the constellation of symptoms including weight loss, jaundice, palpable mass in the right upper quadrant, and elevated bilirubin and alkaline phosphatase levels. These findings are indicative of a pancreatic head mass causing obstruction of the common bile duct, leading to jaundice and elevated liver enzymes. Gallstones (Choice A) typically present with colicky pain, not a palpable mass. Hepatitis (Choice B) would present with different liver enzyme patterns and usually lacks a palpable mass. Primary biliary cirrhosis (Choice D) typically presents with pruritus and fatigue, not a palpable mass and jaundice.
A 60-year-old man presents with fatigue, polyuria, and polydipsia. Laboratory tests reveal hyperglycemia and ketonuria. What is the most likely diagnosis?
- A. Type 1 diabetes mellitus
- B. Type 2 diabetes mellitus
- C. Diabetes insipidus
- D. Hyperthyroidism
Correct Answer: A
Rationale: The most likely diagnosis for a 60-year-old man with fatigue, polyuria, polydipsia, hyperglycemia, and ketonuria is Type 1 diabetes mellitus. The key clues are the presence of ketonuria, which indicates the body is breaking down fats for energy due to lack of insulin in Type 1 diabetes. Additionally, the acute onset of symptoms in an older individual suggests an autoimmune destruction of pancreatic beta cells seen in Type 1 diabetes. Type 2 diabetes is less likely due to the acute presentation and ketonuria. Diabetes insipidus presents with polyuria but not hyperglycemia or ketonuria. Hyperthyroidism typically presents with symptoms such as weight loss, tremors, and heat intolerance, not the classic symptoms seen in this case.
A client with newly diagnosed type 2 diabetes is preparing for discharge. Which statement by the client indicates a need for further teaching?
- A. I will take my insulin shots only when my blood sugar is high
- B. I need to follow a balanced diet and exercise regularly
- C. I should monitor my blood sugar levels regularly
- D. I need to take my medication as prescribed by my doctor
Correct Answer: A
Rationale: The correct answer is A because insulin shots are not only taken when blood sugar is high in type 2 diabetes. Insulin therapy may be prescribed by the doctor to be taken at specific times regardless of blood sugar levels to manage the condition effectively. Choice B is correct as it emphasizes the importance of lifestyle modifications in managing diabetes. Choice C is correct as monitoring blood sugar levels is crucial for managing diabetes. Choice D is correct as adherence to prescribed medication is essential in controlling blood sugar levels.