Nokea
A client with diabetes mellitus is being educated on the importance of foot care. Which of the following instructions should the nurse include?
- A. Soak your feet daily to maintain cleanliness.
- B. Wear tight-fitting shoes to protect your feet.
- C. Apply lotion between your toes to prevent dryness.
- D. Inspect your feet daily for any cuts or sores.
Correct Answer: D
Rationale: The correct answer is to instruct the client to inspect their feet daily for any cuts or sores. This is crucial for individuals with diabetes as they are at a higher risk of developing foot problems. Soaking feet daily can lead to skin breakdown and infections, making choice A incorrect. Tight-fitting shoes can cause pressure points and increase the risk of foot injuries, so choice B is incorrect. Applying lotion between the toes can create a moist environment, increasing the risk of fungal infections, making choice C incorrect.
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A healthcare professional is preparing to care for a client with a potassium deficit. The healthcare professional reviews the client's record and determines that the client was at risk for developing the potassium deficit because the client:
- A. Has renal failure.
- B. Requires nasogastric suction.
- C. Has a history of Addison's disease.
- D. Is taking a potassium-sparing diuretic.
Correct Answer: B
Rationale: Nasogastric suction can lead to significant potassium loss due to the continuous drainage of gastric contents, increasing the risk of a potassium deficit. Choices A, C, and D do not directly result in the significant loss of potassium. Renal failure may lead to potassium retention rather than a deficit. Addison's disease is associated with adrenal insufficiency, not potassium depletion. Potassium-sparing diuretics, as the name suggests, typically help retain potassium rather than cause a deficit.
A client with hypothyroidism is receiving levothyroxine therapy. The healthcare provider should monitor for which of the following signs of medication overdose?
- A. Bradycardia
- B. Weight gain
- C. Tachycardia
- D. Cold intolerance
Correct Answer: C
Rationale: The correct answer is C: Tachycardia. Tachycardia is a sign of levothyroxine overdose, indicating that the dose may need to be adjusted. Bradycardia (Choice A) is a sign of hypothyroidism, not an overdose of levothyroxine. Weight gain (Choice B) and cold intolerance (Choice D) are also symptoms of hypothyroidism, not medication overdose.
A nurse is preparing a plan of care for a client with DM who has hyperglycemia. The priority nursing diagnosis would be:
- A. High risk for deficient fluid volume
- B. Deficient knowledge: disease process and treatment
- C. Imbalanced nutrition: less than body requirements
- D. Disabled family coping: compromised
Correct Answer: A
Rationale: The priority nursing diagnosis for a client with diabetes mellitus (DM) experiencing hyperglycemia would be 'High risk for deficient fluid volume.' Hyperglycemia can lead to osmotic diuresis, causing significant fluid loss and an increased risk of deficient fluid volume. This nursing diagnosis addresses the immediate physiological concern related to fluid balance.\n\nChoice B, 'Deficient knowledge: disease process and treatment,' focuses on the client's understanding of DM, which is important but not the priority when the client is at risk of fluid volume deficit.\n\nChoice C, 'Imbalanced nutrition: less than body requirements,' pertains to inadequate intake of nutrients, which is not the priority concern when fluid volume deficit poses a more immediate threat.\n\nChoice D, 'Disabled family coping: compromised,' addresses a psychosocial aspect and is not the priority over the critical physiological issue of fluid volume deficit in a client with hyperglycemia.
Which of the following is an example of nonmaleficence in nursing practice?
- A. Administering pain medication as prescribed to prevent patient discomfort.
- B. Ensuring that a patient does not receive a treatment that they have refused.
- C. Ensuring that a patient receives appropriate care without causing harm.
- D. Encouraging a patient to express their concerns and fears about a procedure.
Correct Answer: B
Rationale: Nonmaleficence is the ethical principle of doing no harm. In nursing practice, ensuring that a patient does not receive a treatment they have refused is an example of nonmaleficence. Choice A focuses on beneficence by providing pain relief. Choice C is more aligned with beneficence as it emphasizes providing appropriate care without harm. Choice D pertains to patient communication but does not directly address the concept of nonmaleficence.
Which of the following symptoms would be most concerning in a client with diabetes insipidus?
- A. Polydipsia
- B. Polyuria
- C. Nocturia
- D. Hypertension
Correct Answer: D
Rationale: In a client with diabetes insipidus, excessive thirst (polydipsia) and excessive urination (polyuria) are expected symptoms due to the inability to concentrate urine, leading to dilute urine production. Nocturia, waking up at night to urinate, is also common. However, hypertension is not a typical symptom of diabetes insipidus. The correct answer is D because hypertension may indicate a complication such as dehydration or electrolyte imbalances, which would require further assessment in a client with diabetes insipidus.