Nokea
An adolescent with newly diagnosed Type I diabetes mellitus asks the nurse if he can continue to play football. What is the best answer for the nurse to give?
- A. Now that you have diabetes, you should not play football because you may get a cut that will not heal.'
- B. If you work with your physician to regulate the insulin dosage and your diet, you should be able to play football.'
- C. It would be better for you to work as equipment manager so you will not be under as much stress.'
- D. You can probably continue to play football if you can regulate it so that you have the same amount of exercise each day.'
Correct Answer: B
Rationale: With proper insulin and diet management, the adolescent can safely play football, supporting physical activity and normalcy.
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The nurse is discussing discharge plans with a client who had a transsphenoidal hypophysectomy. Which statement made by the client indicates a need for more teaching?
- A. I won't brush my teeth until the doctor removes the stitches.'
- B. I will wear loafers instead of tie shoes.'
- C. Where can I get a Medic-Alert bracelet?'
- D. I will take all these new medicines until I feel better.'
Correct Answer: D
Rationale: Stopping medications when feeling better indicates a lack of understanding, as lifelong hormone replacement is often required post-hypophysectomy.
The nurse is caring for the client who had a thyroidectomy 2 days ago. Based on the findings of the client's serum laboratory report, which medication should the nurse plan to administer first?
- A. Potassium chloride 20 mEq oral bid
- B. Calcium gluconate 4.5 mEq IV once
- C. Dolasetron 12.5 mg IV as needed
- D. Levothyroxine 50 mcg oral daily
Correct Answer: B
Rationale: The serum calcium is critically low (6 mg/dL). Calcium gluconate addresses hypocalcemia from parathyroid gland damage during thyroidectomy.
The client diagnosed with Addison's disease is admitted to the emergency department after a day at the lake. The client is lethargic, forgetful, and weak. Which intervention should the nurse implement?
- A. Start an IV with an 18-gauge needle and infuse NS rapidly.
- B. Have the client wait in the waiting room until a bed is available.
- C. Obtain a permit for the client to receive a blood transfusion.
- D. Collect urinalysis and blood samples for a CBC and calcium level.
Correct Answer: A
Rationale: Lethargy, confusion, and weakness suggest Addisonian crisis; rapid NS infusion corrects hypotension and dehydration. Waiting, transfusions, and labs are inappropriate first steps.
Which client statement indicates a correct understanding of corticosteroid therapy for Addison's disease?
- A. I can stop the medication if I feel better.
- B. I need to take this medication daily.
- C. I should take it only during stress.
- D. I can double the dose if I'm sick.
Correct Answer: B
Rationale: Corticosteroid therapy for Addison's disease requires daily administration to replace deficient hormones and maintain physiological balance.
The nurse is developing a care plan for the client diagnosed with type 1 diabetes. The nurse identifies the problem 'high risk for hyperglycemia related to noncompliance with the medication regimen.' Which statement is an appropriate short-term goal for the client?
- A. The client will have a blood glucose level between 90 and 140 mg/dL.
- B. The client will demonstrate appropriate insulin injection technique.
- C. The nurse will monitor the client's blood glucose levels four (4) times a day.
- D. The client will maintain normal kidney function with 30-mL/hr urine output.
Correct Answer: B
Rationale: Demonstrating correct insulin injection technique addresses noncompliance, a short-term, client-centered goal. Glucose levels and kidney function are outcomes, and nurse monitoring is not client-focused.