Nokea
A client with type 1 DM is admitted to the hospital with diabetic ketoacidosis (DKA). The nurse should prioritize which action?
- A. Administering intravenous fluids.
- B. Administering oral glucose.
- C. Administering a fever-reducing medication.
- D. Administering oxygen therapy.
Correct Answer: A
Rationale: Administering intravenous fluids is the priority in treating DKA for several reasons. DKA is characterized by severe dehydration and electrolyte imbalances due to hyperglycemia. IV fluids help to correct dehydration, restore electrolyte balance, and decrease blood glucose levels. Administering oral glucose (Choice B) would be contraindicated in DKA as the primary issue is high blood glucose levels. Administering a fever-reducing medication (Choice C) is not the priority in managing DKA. Administering oxygen therapy (Choice D) may be necessary in some cases, but correcting dehydration and electrolyte imbalances take precedence in the management of DKA.
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Which of the following best describes the nurse's role in maintaining patient dignity?
- A. The nurse ensures that the patient is treated with respect and that their personal beliefs and values are considered in their care.
- B. The nurse maintains the patient's dignity by ensuring privacy during personal care activities.
- C. The nurse ensures that the patient's personal information is kept private and only shared with those directly involved in their care.
- D. The nurse ensures that the patient is involved in decisions about their care and that their preferences are respected.
Correct Answer: A
Rationale: The correct answer is A. The nurse's role in maintaining patient dignity goes beyond just privacy during personal care activities. It involves treating the patient with respect, considering their personal beliefs and values in their care. While privacy is important for dignity, respecting personal beliefs and values is equally crucial. Choice B focuses solely on privacy, overlooking the broader aspects of dignity maintenance. Choices C and D, although important in patient care, do not fully capture the comprehensive approach needed for maintaining patient dignity as described in choice A.
A client with DM is scheduled for surgery. The nurse should plan to:
- A. Monitor the client's blood glucose level closely during the perioperative period.
- B. Give the client a regular diet as ordered.
- C. Have the client stop taking insulin 48 hours before surgery.
- D. Hold the client's insulin on the morning of surgery.
Correct Answer: A
Rationale: The correct answer is to monitor the client's blood glucose level closely during the perioperative period. For a client with diabetes mellitus (DM) scheduled for surgery, it is essential to closely monitor blood glucose levels to prevent hypo- or hyperglycemia. Choice B is incorrect because giving the client a regular diet as ordered may not address the specific needs related to managing blood glucose levels in the perioperative period. Choice C is incorrect as abruptly stopping insulin 48 hours before surgery can lead to uncontrolled blood sugar levels, which is not recommended. Choice D is incorrect because holding the client's insulin on the morning of surgery can also disrupt blood sugar control, potentially leading to complications during the perioperative period.
The nurse is caring for a client with syndrome of inappropriate antidiuretic hormone (SIADH). Which of the following clinical findings should the nurse expect?
- A. Hyponatremia
- B. Hyperkalemia
- C. Hypercalcemia
- D. Hypernatremia
Correct Answer: A
Rationale: In SIADH, there is excessive release of antidiuretic hormone (ADH), leading to water retention and dilutional hyponatremia. Hyponatremia is a hallmark finding in SIADH due to the imbalance between water and sodium levels. Hyperkalemia (Choice B) is not typically associated with SIADH. Hypercalcemia (Choice C) involves elevated calcium levels, which are not directly related to SIADH. Hypernatremia (Choice D) is the opposite of what occurs in SIADH, where sodium levels are usually diluted due to water retention.
The nurse is caring for a client with a history of adrenal insufficiency. The nurse should monitor for which of the following signs of an Addisonian crisis?
- A. Hypertension
- B. Hyperglycemia
- C. Severe hypotension
- D. Tachycardia
Correct Answer: C
Rationale: In an Addisonian crisis, there is a lack of adrenal hormones leading to severe hypotension. Hypertension (choice A) is not a typical sign of Addisonian crisis but can occur in conditions like pheochromocytoma. Hyperglycemia (choice B) is not a characteristic sign of an Addisonian crisis. Tachycardia (choice D) may occur as a compensatory mechanism in response to hypotension, but severe bradycardia is more common in an Addisonian crisis.
After taking glipizide (Glucotrol) for 9 months, a male client experiences secondary failure. What would the nurse expect the physician to do?
- A. Initiate insulin therapy.
- B. Switch the client to a different oral antidiabetic agent.
- C. Prescribe an additional oral antidiabetic agent.
- D. Restrict carbohydrate intake to less than 30% of the total caloric intake.
Correct Answer: A
Rationale: When a client experiences secondary failure to an oral antidiabetic agent like glipizide, the next step is often to initiate insulin therapy. This is because secondary failure indicates that the current oral antidiabetic medication is no longer effective in managing blood glucose levels, and insulin therapy may be required to adequately control blood sugar. Switching to a different oral antidiabetic agent may not be effective if there is already resistance to the current agent. Adding another oral antidiabetic agent may not address the underlying issue of secondary failure. Restricting carbohydrate intake is important for diabetes management but is not the primary intervention indicated in this scenario of secondary failure to glipizide.