Nokea
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.
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When creating a care plan for a 70-year-old obese client admitted to the postsurgical unit following a colon resection, the client's age and increased body mass index put them at increased risk for which complication in the postoperative period?
- A. Hyperglycemia
- B. Azotemia
- C. Falls
- D. Infection
Correct Answer: D
Rationale: The correct answer is D: Infection. Postoperative obese patients are at higher risk for surgical site infections due to impaired wound healing, decreased tissue oxygenation, and increased tissue pressure. Obesity also compromises the immune system, further increasing susceptibility to infections. Age is a risk factor for infection as well, as older adults may have weakened immune responses. Hyperglycemia (choice A) is a common issue in obese patients but not specifically related to postoperative complications. Azotemia (choice B) refers to elevated levels of nitrogen-containing compounds in the blood and is not directly related to obesity or age. Falls (choice C) are more related to mobility issues and environmental factors, not specifically to age and obesity in the postoperative period.
A client with diabetes has a new prescription for 14 units of regular insulin and 28 units of NPH insulin subcutaneously at breakfast daily. What is the total number of units of insulin that should be prepared in the insulin syringe?
- A. 42 units
- B. 14 units
- C. 28 units
- D. 32 units
Correct Answer: A
Rationale: The correct answer is A: 42 units. To calculate the total number of units of insulin to be prepared in the syringe, you need to add the units of regular insulin (14 units) and NPH insulin (28 units). Therefore, 14 units + 28 units = 42 units. This is the total amount of insulin that should be drawn up and administered subcutaneously.
Summary of other choices:
B: 14 units - This is only the amount of regular insulin and doesn't include the NPH insulin.
C: 28 units - This is only the amount of NPH insulin and doesn't include the regular insulin.
D: 32 units - This is the sum of 14 units of regular insulin and 18 units of NPH insulin, which is incorrect as the NPH insulin prescribed is 28 units, not 18 units.
After a client with ascites due to liver cirrhosis undergoes a paracentesis, what should the nurse do post-procedure?
- A. Encourage the client to drink plenty of fluids
- B. Monitor the client's blood pressure and heart rate
- C. Position the client flat on their back
- D. Administer a dose of furosemide
Correct Answer: B
Rationale: The correct answer is B: Monitor the client's blood pressure and heart rate. Post-paracentesis, there is a risk of hypotension due to sudden fluid shift. Monitoring BP and HR is crucial to detect and manage any hemodynamic changes promptly. Encouraging fluid intake (choice A) may exacerbate ascites. Positioning flat (choice C) may lead to hypotension. Administering furosemide (choice D) without monitoring vital signs can worsen hypotension.
A client with hepatic encephalopathy exhibits confusion, difficulty arousing from sleep, and rigid extremities. Based on these clinical findings, what stage of hepatic encephalopathy should the nurse document?
- A. Stage 1
- B. Stage 2
- C. Stage 3
- D. Stage 4
Correct Answer: C
Rationale: The correct answer is C: Stage 3. In hepatic encephalopathy, Stage 3 is characterized by severe confusion, difficulty arousing from sleep, and potential development of rigid extremities due to worsening brain function. This stage indicates significant impairment and requires immediate medical attention. Stage 1 and 2 are milder forms with less severe symptoms, while Stage 4 represents coma and severe neurological dysfunction, which is beyond the presented symptoms. Therefore, based on the client's clinical findings of confusion, difficulty arousing from sleep, and rigid extremities, Stage 3 is the most appropriate stage to document.
A client's healthcare provider has ordered a 'liver panel' in response to the client's development of jaundice. When reviewing the results of this laboratory testing, the nurse should expect to review what blood tests? Select one that doesn't apply.
- A. Alanine aminotransferase (ALT)
- B. C-reactive protein (CRP)
- C. Gamma-glutamyl transferase (GGT)
- D. Aspartate aminotransferase (AST)
Correct Answer: B
Rationale: The correct answer is B: C-reactive protein (CRP). A liver panel typically includes tests such as ALT, GGT, and AST to assess liver function, but CRP is not part of a standard liver panel. CRP is a marker of inflammation and infection, not specific to liver function. Therefore, when reviewing the results of a liver panel for a client with jaundice, the nurse should not expect to see CRP among the blood tests.