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A client with diabetes mellitus is experiencing hyperglycemia. What laboratory value should the nurse monitor to evaluate long-term glucose control?
- A. Blood glucose level
- B. Glycosylated hemoglobin (A1C)
- C. Urine output
- D. Serum ketone level
Correct Answer: B
Rationale: The correct answer is B: Glycosylated hemoglobin (A1C). Glycosylated hemoglobin reflects long-term glucose control over the past three months. Monitoring blood glucose levels provides information on the current glucose status and immediate control, but it does not give a comprehensive view of long-term control. Urine output and serum ketone levels are important indicators for other aspects of diabetes management, such as hydration status and ketone production during hyperglycemic episodes, but they do not directly reflect long-term glucose control.
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A 78-year-old client with diabetes is being taught how to care for his feet. Which statement by the client indicates a need for further education?
- A. I will soak my feet in warm water every day.
- B. I will use a mirror to check my feet every day.
- C. I will apply lotion to my feet every day, avoiding the area between the toes.
- D. I will wear properly fitting shoes at all times.
Correct Answer: A
Rationale: The correct answer is A. Soaking feet daily can lead to excessive moisture, which can increase the risk of skin breakdown or infection in diabetic clients. Choices B, C, and D are all correct statements for foot care in diabetic clients. Using a mirror for daily foot checks helps in early detection of any issues, applying lotion while avoiding the area between the toes helps keep the skin moisturized without creating a risk for fungal infections, and wearing properly fitting shoes is important to prevent pressure points and potential injuries.
The nurse is administering a new medication to a client. What is the priority action before administering the drug?
- A. Verify the client's allergies
- B. Check the client's blood pressure
- C. Assess the client's pain level
- D. Provide client education on the medication
Correct Answer: A
Rationale: Verifying the client's allergies is the priority action before administering any medication. It is crucial to identify any known allergies to prevent potential allergic reactions, which can be severe and life-threatening. Checking the client's blood pressure, assessing pain levels, and providing education on the medication are important aspects of client care but verifying allergies is essential for ensuring the safety of the client.
The nurse is developing a teaching plan for a client receiving chemotherapy. Which of the following should be the nurse's first priority?
- A. The client will maintain adequate nutrition.
- B. The client will manage side effects of treatment.
- C. The client will recognize signs and symptoms of infection.
- D. The client will experience a reduction in pain.
Correct Answer: C
Rationale: The correct answer is C. Recognizing signs and symptoms of infection should be the nurse's first priority when developing a teaching plan for a client receiving chemotherapy. Chemotherapy often compromises the immune system, making patients more susceptible to infections. Early identification and prompt treatment of infections are crucial to prevent complications. Options A, B, and D are important aspects of care but recognizing signs of infection takes precedence due to the potential life-threatening consequences in clients undergoing chemotherapy treatment.
An older adult client with chronic emphysema is admitted to the emergency room with acute weakness, palpitations, and vomiting. Which information is most important for the nurse to obtain during the initial interview?
- A. Recent compliance with prescribed medications.
- B. Sleep patterns during the previous few weeks.
- C. History of smoking over the past 6 months.
- D. Activity level prior to the onset of symptoms.
Correct Answer: A
Rationale: The correct answer is A: Recent compliance with prescribed medications. In a client with chronic emphysema experiencing acute symptoms, it is crucial to assess medication compliance as it directly impacts the management of the condition and could contribute to the current presentation. Ensuring that the client has been taking their prescribed medications can provide vital information to guide further treatment. Choices B, C, and D, although important in a comprehensive assessment, are not as immediately crucial as assessing medication compliance in this emergency situation.
The client is being taught about precautions with Coumadin therapy. The client should be instructed to avoid which over-the-counter medication?
- A. Non-steroidal anti-inflammatory drugs
- B. Cough medicines containing guaifenesin
- C. Histamine blockers
- D. Laxatives containing magnesium salts
Correct Answer: A
Rationale: The correct answer is A: Non-steroidal anti-inflammatory drugs (NSAIDs). NSAIDs can increase the risk of bleeding in clients taking Coumadin, which is an anticoagulant medication. Avoiding NSAIDs helps prevent potentially dangerous interactions with Coumadin. Choices B, C, and D are incorrect. Cough medicines with guaifenesin, histamine blockers, and laxatives containing magnesium salts do not typically have significant interactions with Coumadin therapy. Therefore, they are not the over-the-counter medications that the client needs to avoid while on Coumadin.