Nokea
An elderly client with Type 2 diabetes mellitus develops an ingrown toenail. What is the best action for the nurse to take?
- A. Put cotton under the nail and clip the nail straight across
- B. Elevate the foot immediately
- C. Apply warm, moist soaks
- D. Notify the physician
Correct Answer: D
Rationale: An ingrown toenail in a diabetic client risks infection and poor healing, requiring physician evaluation rather than self-treatment.
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Which nursing interventions are most appropriate for nursing in the health of a client with Cushing's syndrome? Select all that apply.
- A. Have the client sleep on a convoluted (egg-crate) foam mattress.
- B. Ambulate the client at frequent intervals.
- C. Advise the client to ask for assistance when getting up.
- D. Offer high-carbohydrate nourishment.
- E. Check the client frequently for suicidal ideation.
- F. Instruct the client to wear loose-fitting clothing.
Correct Answer: A,C,E,F
Rationale: These interventions address skin breakdown, fall risk, mood changes, and comfort in Cushing's syndrome.
A client develops hypoparathyroidism after a total thyroidectomy. What treatment should the nurse anticipate?
- A. Emergency tracheostomy
- B. Administration of calcium
- C. Oxygen administration
- D. Administration of potassium
Correct Answer: B
Rationale: Hypoparathyroidism causes hypocalcemia, requiring calcium administration to prevent tetany and other complications.
The client with type 2 DM is scheduled for cardiac rehabilitation exercises (cardiac rehab). The nurse notes that the client's blood glucose level is 300 mg/dL and that the urine is positive for ketones. How should the nurse proceed?
- A. Send the client to cardiac rehab; exercise will lower the client's glucose level.
- B. Give insulin; send the client for exercises with a 15-gram carbohydrate snack.
- C. Delay cardiac rehab; blood glucose levels will decrease too much with exercise.
- D. Cancel cardiac rehab; blood glucose levels will increase further with exercise.
Correct Answer: D
Rationale: Exercising with blood glucose levels exceeding 250 mg/dL and ketonuria increases the secretion of glucagon, growth hormone, and catecholamines, causing the liver to release more glucose.
Which client history is most significant in the development of symptoms for a client who has iatrogenic Cushing's disease?
- A. Long-term use of anabolic steroids.
- B. Extended use of inhaled steroids for asthma.
- C. History of long-term glucocorticoid use.
- D. Family history of increased cortisol production.
Correct Answer: C
Rationale: Long-term glucocorticoid use causes iatrogenic Cushing’s by mimicking hypercortisolism. Anabolic/inhabited steroids and family history are less causative.
Which client statement indicates the need for further teaching about thyroidectomy postoperative care?
- A. I should support my neck when sitting up.
- B. I may need calcium supplements.
- C. I can resume normal activities immediately.
- D. I should report any voice changes.
Correct Answer: C
Rationale: Resuming normal activities immediately post-thyroidectomy is incorrect due to the risk of complications like bleeding or hypocalcemia.