A client with type 2 diabetes mellitus (DM) is admitted to the hospital for uncontrolled DM. Insulin therapy is initiated with an initial dose of Humulin N insulin at 0800. At 1600, the client complains of diaphoresis, rapid heartbeat, and feeling shaky. What should the nurse do first?
- A. Determine the client's current glucose level
- B. Administer 10 units of fast-acting insulin.
- C. Offer the client a snack with high protein.
- D. Increase the IV infusion rate of normal saline.
Correct Answer: A
Rationale: The symptoms suggest hypoglycemia. Checking the glucose level confirms the diagnosis and guides appropriate treatment.
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In childhood, hypokalaemic alkalosis is a recognised finding:
- A. In a baby given feeds that are too concentrated
- B. In congenital pyloric stenosis
- C. In cystic fibrosis
- D. Following urinary diversion
Correct Answer: B
Rationale: Hypokalaemic alkalosis is a hallmark of congenital pyloric stenosis due to vomiting. It is not typically associated with concentrated feeds, cystic fibrosis, or urinary diversion.
Spread of hepatitis C occurs by:
- A. Drug abuse
- B. Seafood consumption
- C. Recombinant factor VIII therapy
- D. Faeco-oral spread
Correct Answer: A
Rationale: Hepatitis C is primarily spread through blood-to-blood contact, such as sharing needles or other equipment to inject drugs.
The following are potent vasoconstrictors:
- A. Renin
- B. Angiotensin I
- C. Nitric oxide
- D. PGI2
Correct Answer: A
Rationale: Renin: Renin is a precursor enzyme in the RAAS that helps in converting angiotensinogen into angiotensin I, a potent vasoconstrictor.
Hemolytic anaemia is characterised by:
- A. Increased haptoglobin
- B. Haemosiderinuria
- C. Polychromasia
- D. Megaloblastic bone marrow
Correct Answer: B
Rationale: Haemosiderinuria: Hemolytic anaemia often leads to the release of heme, which is broken down into hemosiderin, leading to haemosiderinuria (presence of hemosiderin in urine).
A child of 36 months would be expected to:
- A. Build a tower of 5 cubes
- B. Repeat back 5 digits
- C. Draw a man with a head and body
- D. Demonstrate symbolic play
Correct Answer: D
Rationale: At 36 months, a child is expected to demonstrate symbolic play. Building a tower of 5 cubes and drawing a man with a head and body are also typical milestones.
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