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Capillary glucose monitoring is being performed every 4 hours for a female client diagnosed with diabetic ketoacidosis. Insulin is administered using a scale of regular insulin according to glucose results. At 2 p.m., the client has a capillary glucose level of 250 mg/dl for which she receives 8 U of regular insulin. Nurse Vince should expect the dose's:
- A. Onset to be at 2 p.m. and its peak to be at 3 p.m.
- B. Onset to be at 2:15 p.m. and its peak to be at 3 p.m.
- C. Onset to be at 2:30 p.m. and its peak to be at 4 p.m.
- D. Onset to be at 4 p.m. and its peak to be at 6 p.m.
Correct Answer: C
Rationale: The correct answer is C. Regular insulin typically has an onset of action within 30 minutes and peaks 2-4 hours after administration. Given that the insulin was administered at 2 p.m., the onset of action can be expected around 2:30 p.m., and the peak effect would occur between 4-6 p.m. Choice A is incorrect as the onset and peak are too close together for regular insulin. Choice B is incorrect because the onset time is too soon after administration. Choice D is incorrect as the onset time is too delayed for regular insulin.
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In a male client with a history of hypertension diagnosed with primary hyperaldosteronism, the hypertension is caused by excessive hormone secretion from which of the following glands?
- A. Adrenal cortex
- B. Pancreas
- C. Adrenal medulla
- D. Parathyroid
Correct Answer: A
Rationale: Primary hyperaldosteronism is characterized by excessive secretion of aldosterone from the adrenal cortex. Aldosterone, a hormone produced by the adrenal cortex, plays a crucial role in regulating blood pressure by promoting sodium and water retention in the kidneys. The adrenal medulla secretes catecholamines like epinephrine and norepinephrine, which are involved in the 'fight or flight' response, not in regulating blood pressure. The pancreas secretes insulin and glucagon, hormones involved in blood sugar regulation, not blood pressure. The parathyroid glands regulate calcium levels in the blood, not blood pressure.
The nurse is teaching a client with newly diagnosed hyperthyroidism about the management of the condition. Which of the following statements by the client indicates a need for further teaching?
- A. I should take my medication every day as prescribed.
- B. I need to avoid foods high in iodine.
- C. I can skip my medication on days when I feel fine.
- D. I should monitor my pulse regularly.
Correct Answer: C
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
A patient with acute congestive heart failure is receiving high doses of a diuretic. On assessment, the nurse notes flat neck veins, generalized muscle weakness, and diminished deep tendon reflexes. Suspecting hyponatremia, what additional signs would the nurse expect to note in this patient if hyponatremia were present?
- A. Dry skin
- B. Decreased urinary output
- C. Hyperactive bowel sounds
- D. Increased specific gravity of the urine
Correct Answer: C
Rationale: In a patient with hyponatremia, hyperactive bowel sounds are expected due to increased gastrointestinal motility. Dry skin (Choice A) is not a typical sign of hyponatremia. Decreased urinary output (Choice B) is more commonly associated with conditions like dehydration or renal issues, not specifically hyponatremia. Increased specific gravity of the urine (Choice D) is a sign of concentrated urine, which is not a characteristic finding in hyponatremia.
The healthcare provider is monitoring a client with Cushing's syndrome. Which of the following findings should be reported to the healthcare provider immediately?
- A. Hyperglycemia
- B. Hypertension
- C. Low-grade fever
- D. Weight gain
Correct Answer: C
Rationale: In a client with Cushing's syndrome, a low-grade fever should be reported immediately as it may indicate an infection. Clients with Cushing's syndrome are immunosuppressed, making them more susceptible to infections. Hyperglycemia and hypertension are common findings in Cushing's syndrome and are managed as part of the condition. Weight gain is also a common symptom in Cushing's syndrome and may not require immediate reporting unless it is sudden and severe.
During preoperative teaching for a female client undergoing subtotal thyroidectomy, which statement should the nurse include?
- A. The head of your bed must remain flat for 24 hours after surgery.
- B. You should avoid deep breathing and coughing after surgery.
- C. You won't be able to swallow for the first day or two.
- D. You must avoid hyperextending your neck after surgery.
Correct Answer: D
Rationale: The correct answer is D. Instructing the client to avoid hyperextending the neck after thyroid surgery is crucial to prevent stress on the surgical site and reduce the risk of complications such as strain on the incision or damage to the healing tissues. Choices A, B, and C are incorrect because:
A) Keeping the head of the bed flat for 24 hours is not necessary after a thyroidectomy; elevation of the head of the bed can actually help reduce swelling and improve comfort.
B) Encouraging deep breathing and coughing after surgery is essential to prevent respiratory complications such as pneumonia, so this advice is incorrect.
C) Difficulty swallowing after thyroid surgery is not a typical outcome, so this statement is inaccurate and should not be included in the preoperative teaching.