Nokea
A client is diagnosed as having insulin-dependent diabetes mellitus (IDDM). She received regular insulin at 7:30 A.M. When is she most apt to develop a hypoglycemic reaction?
- A. Mid-morning
- B. Mid-afternoon
- C. Early evening
- D. During the night
Correct Answer: A
Rationale: Regular insulin peaks 2-4 hours after administration, making mid-morning (9:30-11:30 A.M.) the most likely time for hypoglycemia.
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The nurse at a freestanding health-care clinic is caring for a 56-year-old male client who is homeless and is a type 2 diabetic controlled with insulin. Which action is an example of client advocacy?
- A. Ask the client if he has somewhere he can go and live.
- B. Arrange for someone to give him insulin at a local homeless shelter.
- C. Notify Adult Protective Services about the client's situation.
- D. Ask the HCP to take the client off insulin because he is homeless.
Correct Answer: B
Rationale: Arranging insulin administration at a shelter ensures the client’s medical needs are met, advocating for his health. Housing questions, APS notification, and stopping insulin are less supportive.
The nurse is planning the care of a client diagnosed with Addison's disease. Which intervention should be included?
- A. Administer steroid medications.
- B. Place the client on fluid restriction.
- C. Provide frequent stimulation.
- D. Consult physical therapy for gait training.
Correct Answer: A
Rationale: Steroid replacement (e.g., hydrocortisone) is essential for Addison’s to replace deficient cortisol/aldosterone. Fluid restriction, stimulation, and gait training are inappropriate.
Before the client is discharged, the physician orders lypressin (Diapid) to be administered p.r.n. When instructing the client about how to take this drug at home, the nurse tells the client to administer the drug when experiencing which sign or symptom?
- A. Increased thirst
- B. Onset of a headache
- C. Dark yellow urine
- D. A runny nose
Correct Answer: A
Rationale: Increased thirst is a symptom of diabetes insipidus indicating the need for lypressin to control fluid loss.
Which client problem has priority for the client diagnosed with acute pancreatitis?
- A. Risk for fluid volume deficit.
- B. Alteration in comfort.
- C. Imbalanced nutrition: less than body requirements.
- D. Knowledge deficit.
Correct Answer: A
Rationale: Fluid volume deficit is the priority in acute pancreatitis due to vomiting and third-spacing, risking hypovolemia. Pain, nutrition, and knowledge are secondary.
The client diagnosed with HHNS was admitted yesterday with a blood glucose level of 780 mg/dL. The client's blood glucose level is now 300 mg/dL. Which intervention should the nurse implement?
- A. Increase the regular insulin IV drip.
- B. Check the client's urine for ketones.
- C. Provide the client with a therapeutic diabetic meal.
- D. Notify the HCP to obtain an order to decrease insulin.
Correct Answer: D
Rationale: A glucose drop from 780 to 300 mg/dL requires HCP notification to adjust insulin, preventing hypoglycemia. Increasing insulin, checking ketones, or meals are inappropriate.