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A nurse is caring for a client receiving metformin. Which of the following laboratory data should be reported to the provider?
- A. Decreased blood urea nitrogen (BUN) level
- B. Decreased glomerular filtration rate (GFR)
- C. Decreased fasting plasma glucose
- D. Decreased hemoglobin A1C
Correct Answer: B
Rationale: A decreased GFR indicates renal impairment, increasing the risk of metformin-associated lactic acidosis, requiring immediate reporting. Decreased BUN, glucose, and HbA1c are expected or less urgent.
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The nurse is teaching a client who is receiving newly oral prednisone. Which of the following Information should the nurse include concerning the possible side effects of this medication?
- A. Increased susceptibility to infection
- B. Weight gain
- C. Insomnia
- D. Blood glucose elevation
- E. Increased urine output
Correct Answer: A,B,C,D
Rationale: Prednisone, a corticosteroid, suppresses immunity (increasing infection risk), causes weight gain, insomnia, and elevates blood glucose. Increased urine output is not a common side effect; it’s more associated with diuretics.
The nurse is caring for a client with a prescribed subcutaneous (SQ) regular insulin sliding scale. The client's current blood glucose level is 360 mg/dL (19.98 mmol/L) [70-110 mg/dL, 4.0-11.0 mmol/L]. Which of the following actions should the nurse take? See the exhibit.
- A. Notify the primary health care provider (PHCP).
- B. Administer 8 units of regular insulin.
- C. Administer 10 units of regular insulin.
- D. Recheck the client's blood glucose in one hour.
- E. Administer the insulin intravenous (IV) push.
Correct Answer: A,B
Rationale: A blood glucose of 360 mg/dL is significantly elevated, requiring insulin per the sliding scale (e.g., 8 units for 351–400 mg/dL, depending on the exhibit) and PHCP notification for further management. IV push is inappropriate for SQ scales, and rechecking in one hour follows administration.
The following scenario applies to the next 1 items
The home health nurse visits a client with chronic diabetes insipidus
Item 1 of 1
Nurses’ Note
1415 – Home health visit completed because the client was admitted to the hospital twice in the past six weeks for treatment nonadherence related to diabetes insipidus. Extensive teaching provided and reviewed education on prescribed desmopressin intranasal, maintenance of fluids, daily weight, intake and output, and when to seek emergency care.
Which client statements would indicate a correct understanding of the teaching?
- A. I should limit the amount of fluids that I drink after 5:00 PM.
- B. I will need to weigh myself at the same time every day.
- C. I should put both doses of the desmopressin in one nostril.
- D. I need to keep a log of my fluid intake and urine output.
- E. I may need an additional dose if I keep urinating a lot.
- F. If I develop confusion with this medication, I should call 911.
Correct Answer: B, D, F
Rationale: Daily weighing and logging intake/output monitor diabetes insipidus. Confusion may signal hyponatremia, needing emergency care. Fluid limits are incorrect, desmopressin dosing is per nostril, and extra doses require a provider's order.
The nurse is discussing the functions of the parathyroid hormone (PTH) with a student. Which of the following statements would be correct for the nurse to make? The parathyroid hormone
- A. moves calcium from bones to the bloodstream.
- B. promotes renal tubular reabsorption of calcium.
- C. controls bodily functions such as metabolism and heart rate.
- D. promotes renal tubular reabsorption of phosphorus.
- E. causes the retention of sodium and the excretion of potassium.
Correct Answer: A, B
Rationale: PTH raises blood calcium by mobilizing it from bones and increasing renal reabsorption. Metabolism and heart rate are thyroid functions, and PTH reduces, not increases, phosphorus reabsorption.
The nurse caring for a diabetes mellitus client obtained a scheduled capillary blood glucose. The result indicated 40 mg/dL (2.22 mmol/L) [70-110 mg/dL, 4.0-11.0 mmol/L]. The client reports no symptoms. The initial action of the nurse should be which of the following?
- A. Document the finding in the medical record
- B. Repeat the capillary blood glucose test to validate the result
- C. Administer 15 grams of a quick-acting carbohydrate
- D. Administer 1 mg of glucagon subcutaneously
Correct Answer: B
Rationale: A glucose of 40 mg/dL is critically low, even without symptoms. Repeating the test validates the result, ensuring accuracy before treatment to avoid unnecessary intervention.