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A nurse is providing teaching to a client who has type 1 diabetes mellitus. Which of the following statements by the client indicates an understanding of the teaching?
- A. Albumin in my urine is an indication of normal kidney function.
- B. I will keep my HbA1c at five percent.
- C. I will have ketones in my urine if my blood glucose is maintained at 190 milligrams per deciliter.
- D. I will keep my blood glucose levels between 200 and 212 milligrams per deciliter.
Correct Answer: B
Rationale: The correct answer is B. Maintaining an HbA1c level of 5 percent indicates good long-term blood glucose control and understanding of diabetes management. Choice A is incorrect because the presence of albumin in the urine (albuminuria) is actually an indication of kidney damage in diabetes. Choice C is incorrect as ketones in the urine are a sign of inadequate insulin and can occur when blood glucose levels are high, not at a specific level like 190 mg/dL. Choice D is also incorrect as the client should aim to keep blood glucose levels within a tighter range for better control, typically between 80-130 mg/dL before meals and less than 180 mg/dL after meals.
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A nurse is teaching a group of clients about stress. Which of the following should the nurse include in the teaching?
- A. Protein requirements decrease in times of stress.
- B. Acute stress causes an increase in metabolism.
- C. Stress causes a positive nitrogen balance in the body.
- D. Glucose is broken down more slowly during times of stress.
Correct Answer: B
Rationale: The correct answer is B: Acute stress causes an increase in metabolism. During acute stress, the body's fight-or-flight response is activated, leading to an increase in metabolism to provide energy for the body to respond to the stressor. Choices A, C, and D are incorrect. Protein requirements actually increase during times of stress to support the body's needs. Stress typically leads to a negative nitrogen balance in the body, not a positive one. Glucose is broken down more rapidly, not slowly, during times of stress to provide immediate energy.
A client who follows the dietary laws of Orthodox Judaism is being cared for by a nurse. Which of the following meal choices should the nurse request for the client?
- A. Turkey and cheese sandwich
- B. Spaghetti with tomato sauce
- C. Pork chop and applesauce
- D. Scrambled eggs and bacon
Correct Answer: B
Rationale: The correct meal choice for a client following the dietary laws of Orthodox Judaism is 'Spaghetti with tomato sauce.' Orthodox Judaism prohibits mixing meat and dairy and consuming pork. The other choices - 'Turkey and cheese sandwich' (mixing meat and dairy), 'Pork chop and applesauce' (contains pork), and 'Scrambled eggs and bacon' (mixing meat and dairy) - do not adhere to the kosher dietary laws.
A nurse is teaching a client about strategies to prevent constipation. Which of the following statements by the client indicates an understanding of the teaching?
- A. Drinking four to five glasses of water per day will prevent constipation.
- B. I should consume mineral oil once per day.
- C. Eating foods high in fiber will make elimination easier.
- D. I can skip a meal if I feel bloated.
Correct Answer: C
Rationale: The correct answer is C. Eating foods high in fiber increases stool bulk and promotes easier elimination, thus preventing constipation. Choices A, B, and D are incorrect. Drinking water is important, but the emphasis should be on high-fiber foods. Mineral oil is not a recommended first-line treatment for constipation, and skipping meals can disrupt regular bowel movements, potentially leading to constipation.
A healthcare professional is reviewing the lab findings of a client who has Clostridium Difficile. Which of the following findings should indicate to the healthcare professional that the client is experiencing Fluid Volume Deficit?
- A. Hct 53%
- B. Potassium 3.5
- C. Sodium 145
- D. HbA1c 5
Correct Answer: A
Rationale: An elevated hematocrit level (Hct 53%) indicates hemoconcentration, a sign of fluid volume deficit. Hct measures the percentage of red blood cells in the blood and increases when there is a decrease in plasma volume, as seen in fluid volume deficit. Choices B, C, and D do not directly relate to fluid volume status. Potassium and sodium levels are more indicative of electrolyte imbalances, while HbA1c reflects average blood sugar levels over the past 2-3 months and is not specific to fluid volume status.
A nurse is providing teaching about formula feeding to the parents of an infant. Which of the following instructions should the nurse include?
- A. Formula that remains in the bottle should not be used for one more feeding.
- B. Formula should be changed to whole milk when the infant is 12 months old.
- C. If the infant is gaining weight too rapidly, do not dilute the formula.
- D. If the infant turns away after taking most of the feeding, stop the feeding.
Correct Answer: D
Rationale: If the infant turns away after taking most of the feeding, it indicates they are full, and continuing to feed may lead to overfeeding. Choice A is incorrect because it is not safe to use formula that remains in the bottle for another feeding due to the risk of bacterial contamination. Choice B is incorrect as whole milk should be introduced after the infant is 12 months old, not 9 months old. Choice C is incorrect as diluting formula can compromise the infant's nutrition and should not be done without healthcare provider guidance.