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A healthcare professional is reviewing the laboratory findings of a client who has diabetes mellitus. Which of the following findings indicates a need to revise the client's plan of care?
- A. Serum sodium 144 mEq/L.
- B. HbA1c 10%.
- C. Random serum glucose 190 mg/dL.
- D. Creatinine 1.2 mg/dL.
Correct Answer: C
Rationale: Elevated random serum glucose levels of 190 mg/dL indicate hyperglycemia and poor blood sugar control, requiring a revised plan of care. HbA1c levels above 7% also indicate long-term poor control of blood sugar. Serum sodium of 144 mEq/L and creatinine of 1.2 mg/dL are within normal ranges and do not directly indicate a need for a plan of care revision.
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A healthcare provider is assessing a client who has COPD and is receiving oxygen therapy at 2 L/min via nasal cannula. Which of the following findings should the provider report?
- A. Oxygen saturation of 95%.
- B. Productive cough with clear sputum.
- C. Respiratory rate of 22/min.
- D. Client reports dyspnea.
Correct Answer: D
Rationale: The correct answer is D. Dyspnea in a client with COPD receiving oxygen should be reported as it may indicate worsening respiratory status. Oxygen saturation of 95% is within the expected range for a client receiving oxygen therapy and does not require immediate reporting. A productive cough with clear sputum is a common symptom in clients with COPD and does not necessarily warrant urgent reporting. A respiratory rate of 22/min is also within normal limits and does not raise immediate concerns in this scenario.
A client who has a new prescription for spironolactone is being taught by a nurse. Which of the following client statements indicates an understanding of the teaching?
- A. I will avoid foods that are high in potassium.
- B. I will avoid foods that are high in sodium.
- C. I will need to have my blood pressure checked regularly while taking this medication.
- D. I will need to have my potassium levels checked regularly while taking this medication.
Correct Answer: D
Rationale: The correct answer is D because clients taking spironolactone should have their potassium levels checked regularly. Spironolactone is a potassium-sparing diuretic, meaning it helps the body retain potassium and can lead to hyperkalemia if levels become too high. Choices A, B, and C are incorrect because avoiding foods high in potassium, sodium, or monitoring blood pressure are not specific to the teaching related to spironolactone.
A client has a new diagnosis of COPD. Which of the following instructions should the nurse include in the teaching?
- A. Breathe rapidly through your mouth when using the incentive spirometer.
- B. Use pursed-lip breathing during periods of dyspnea.
- C. Avoid drinking fluids during meals.
- D. Use diaphragmatic breathing during periods of dyspnea.
Correct Answer: B
Rationale: Pursed-lip breathing is a beneficial technique for clients with COPD as it helps control shortness of breath and improves oxygenation. This technique involves inhaling slowly through the nose and exhaling through pursed lips, which helps keep airways open. Option A is incorrect as breathing rapidly through the mouth when using the incentive spirometer can lead to hyperventilation. Option C is incorrect because it is important for clients with COPD to stay hydrated by drinking fluids between meals, but not during meals which can cause bloating and discomfort. Option D is incorrect as diaphragmatic breathing, though beneficial, is not the preferred technique for managing dyspnea in COPD; pursed-lip breathing is more effective.
A nurse is providing discharge teaching to a client who has a new prescription for metformin. Which of the following instructions should the nurse include?
- A. Take this medication at bedtime.
- B. You should expect your urine to turn orange while taking this medication.
- C. This medication can cause you to gain weight.
- D. Take this medication with food to reduce gastrointestinal discomfort.
Correct Answer: D
Rationale: The correct answer is D because taking metformin with food helps reduce gastrointestinal discomfort, a common side effect of the medication. Choice A is incorrect as metformin is usually taken with meals to minimize side effects. Choice B is incorrect because metformin does not typically cause urine discoloration. Choice C is incorrect as metformin is associated with weight loss or weight neutrality rather than weight gain.
A nurse is reviewing the laboratory results of a client who has hypocalcemia. Which of the following findings should the nurse expect?
- A. Positive Trousseau's sign
- B. Increased deep tendon reflexes
- C. Hyperactive bowel sounds
- D. Weak, thready pulse
Correct Answer: A
Rationale: A positive Trousseau's sign is a key finding in clients with hypocalcemia, indicating neuromuscular irritability. The other choices are not typically associated with hypocalcemia. Increased deep tendon reflexes are more indicative of hypercalcemia. Hyperactive bowel sounds can be seen in hyperactive bowel conditions or diarrhea, not specifically related to hypocalcemia. A weak, thready pulse may indicate cardiovascular issues, such as dehydration, but it is not a typical finding in hypocalcemia.