Nokea
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.
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A client with type 1 diabetes mellitus is admitted with diabetic ketoacidosis (DKA). Which of the following interventions should be the nurse's priority?
- A. Administer intravenous insulin
- B. Start an intravenous line and infuse normal saline
- C. Monitor serum potassium levels
- D. Obtain an arterial blood gas (ABG)
Correct Answer: B
Rationale: The correct answer is to start an intravenous line and infuse normal saline. In diabetic ketoacidosis (DKA), the priority intervention is fluid resuscitation with normal saline to restore intravascular volume and improve perfusion. Administering insulin without first addressing dehydration and electrolyte imbalances can lead to further complications. Monitoring serum potassium levels and obtaining an arterial blood gas (ABG) are important aspects of DKA management but come after initial fluid resuscitation.
The nurse is caring for a client with myxedema coma. Which of the following interventions should the nurse prioritize?
- A. Administer intravenous fluids
- B. Provide a warming blanket
- C. Administer levothyroxine intravenously
- D. Place the client in Trendelenburg position
Correct Answer: C
Rationale: In myxedema coma, the priority intervention is to administer levothyroxine intravenously. Myxedema coma is a severe form of hypothyroidism, and intravenous levothyroxine is crucial to rapidly replace deficient thyroid hormones. Administering intravenous fluids (choice A) may be necessary, but levothyroxine takes precedence. Providing a warming blanket (choice B) can help maintain the client's body temperature, but it does not address the underlying thyroid hormone deficiency. Placing the client in Trendelenburg position (choice D) is not indicated and can potentially worsen the client's condition.
What is the lowest fasting plasma glucose level suggestive of a diagnosis of DM?
- A. 90 mg/dl.
- B. 115 mg/dl.
- C. 126 mg/dl.
- D. 180 mg/dl.
Correct Answer: C
Rationale: A fasting plasma glucose level of 126 mg/dl or higher is diagnostic of diabetes mellitus. Choice A (90 mg/dl) is too low to indicate diabetes. Choice B (115 mg/dl) is also below the diagnostic threshold for diabetes. Choice D (180 mg/dl) is above the diagnostic threshold and would indicate uncontrolled diabetes, not the lowest level suggestive of a diagnosis.
The nurse is providing dietary instructions to a client with DM. The nurse instructs the client to include which item in the diet?
- A. High-fat foods
- B. Low-carbohydrate foods
- C. High-protein foods
- D. High-fiber foods
Correct Answer: D
Rationale: High-fiber foods are beneficial for clients with diabetes because they help regulate blood glucose levels by slowing down the absorption of sugar. Additionally, high-fiber foods aid in maintaining satiety, supporting weight management, and preventing constipation. High-fat foods (choice A) are not recommended for clients with diabetes due to their potential negative impact on heart health and weight. While low-carbohydrate foods (choice B) can be part of a diabetes-friendly diet, high-fiber foods are more specifically beneficial for managing blood sugar levels. High-protein foods (choice C) can be included in moderation in a diabetic diet, but they are not the primary focus when it comes to improving glycemic control.
What health concerns should Nurse Oliver expect a client with hypothyroidism to report?
- A. Increased appetite and weight loss
- B. Puffiness of the face and hands
- C. Nervousness and tremors
- D. Thyroid gland swelling
Correct Answer: B
Rationale: Puffiness of the face and hands is a classic symptom of hypothyroidism. This occurs due to fluid retention and is commonly observed in individuals with an underactive thyroid gland. Increased appetite and weight loss (Choice A) are more indicative of hyperthyroidism, where there is an overproduction of thyroid hormones leading to increased metabolism. Nervousness and tremors (Choice C) are associated with hyperthyroidism, not hypothyroidism. Thyroid gland swelling (Choice D) typically indicates goiter, which can be present in both hyperthyroidism and hypothyroidism but is not a specific symptom that clients with hypothyroidism commonly report.