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An adolescent with IDDM is learning about a diabetic diet. He asks the nurse if he will ever be able to go out to eat with his friends again. What is the most appropriate answer for the nurse to give?
- A. You can go out with them, but you should take your own snack with you.'
- B. Yes. You will learn what foods are allowed so you can eat with your friends.'
- C. When you get food out in a restaurant, be sure to order diet soft drinks.'
- D. Eating out will not be possible on a diabetic diet. Why don't you plan to invite your friends to your house?'
Correct Answer: B
Rationale: Learning appropriate food choices allows the adolescent to eat out safely, promoting social integration and adherence to the diabetic diet.
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Which question should the nurse ask when assessing the client for an endocrine dysfunction?
- A. Have you noticed any pain in your legs when walking?
- B. Have you had any unexplained weight loss?
- C. Have you noticed any change in your bowel movements?
- D. Have you experienced any joint pain or discomfort?
Correct Answer: B
Rationale: Unexplained weight loss is a hallmark symptom of endocrine disorders like hyperthyroidism or diabetes mellitus, making it a key assessment question. Leg pain relates to vascular issues, bowel changes are less specific, and joint pain is more musculoskeletal.
Which interrelated concepts could be identified as actual or potential for a 56-year-old male client diagnosed with diabetes mellitus type 2? Select all that apply.
- A. Nutrition.
- B. Metabolism.
- C. Infection.
- D. Male reproduction.
- E. Skin integrity.
Correct Answer: A,B,C,E
Rationale: Nutrition, metabolism, infection, and skin integrity are impacted by type 2 diabetes due to dietary needs, glucose control, infection risk, and neuropathy. Male reproduction is less directly affected.
The nurse is preparing to discharge the client following a unilateral adrenalectomy to treat hyperaldosteronism caused by an adenoma. Which instruction should be included in this client's discharge teaching?
- A. Avoid foods high in potassium
- B. Self-monitor blood pressure daily
- C. Stop drugs taken before adrenalectomy
- D. Carry epinephrine for emergency use
Correct Answer: B
Rationale: Self-monitoring BP is necessary as hypertension may persist in 20% of clients post-adrenalectomy.
The nurse evaluates the client who is being treated for DKA. Which finding indicates that the client is responding to the treatment plan?
- A. Eyes sunken and skin flushed
- B. Skin moist with rapid elastic recoil
- C. Serum potassium level is 3.3 mEq/L
- D. ABG results are pH 7.25, PaCO2 30, HCO3 17
Correct Answer: B
Rationale: Moist skin and good skin turgor indicate that dehydration secondary to hyperglycemia is resolving.
The client with type 2 diabetes controlled with biguanide oral diabetic medication is scheduled for a computed tomography (CT) scan with contrast of the abdomen to evaluate pancreatic function. Which intervention should the nurse implement?
- A. Provide a high-fat diet 24 hours prior to test.
- B. Hold the biguanide medication for 48 hours prior to test.
- C. Obtain an informed consent form for the test.
- D. Administer pancreatic enzymes prior to the test.
Correct Answer: B
Rationale: Biguanides (e.g., metformin) are held 48 hours before contrast CT to prevent lactic acidosis due to contrast-induced kidney injury. High-fat diets, consent, and enzymes are irrelevant.