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Diabetes mellitus is a disorder that affects 3.1 out of every 1000 children younger than 20 years old. It is characterized by an absence of, or marked decrease in, circulating insulin. When teaching a newly diagnosed diabetes client, the nurse includes information on the functions of insulin:
- A. Transport of glucose into body cells and storage of glycogen in the liver
- B. Glycogenolysis and facilitation of glucose use for energy
- C. Glycogenolysis and catabolism
- D. Catabolism and hyperglycemia
Correct Answer: A
Rationale: Lack of insulin causes glycogenolysis, catabolism, and hyperglycemia. Insulin promotes the conversion of glucose to glycogen for storage and regulates the rate at which carbohydrates are used by cells for energy. Insulin is anabolic in nature. Glucose stimulates protein synthesis within the tissue and inhibits the breakdown of protein into amino acids.
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The client at 30 weeks gestation is admitted with preterm labor. The physician orders indomethacin. The nurse should monitor for which side effect?
- A. Maternal hypertension
- B. Fetal bradycardia
- C. Oligohydramnios
- D. Maternal hypoglycemia
Correct Answer: C
Rationale: Indomethacin a tocolytic can reduce fetal urine output leading to oligohydramnios (low amniotic fluid). Maternal hypertension fetal bradycardia and hypoglycemia are not common side effects of indomethacin.
The nurse is caring for a client with a diagnosis of gestational hypertension. Which intervention is most appropriate?
- A. Monitor blood pressure
- B. Administer antihypertensives
- C. Monitor fetal heart tones
- D. All of the above
Correct Answer: D
Rationale: Gestational hypertension requires blood pressure monitoring to assess severity antihypertensives for severe hypertension and fetal heart tone monitoring to ensure fetal well-being. All interventions are appropriate.
The nurse is caring for a client with a diagnosis of placenta accreta. Which intervention is most appropriate?
- A. Prepare for possible hysterectomy
- B. Administer tocolytics
- C. Monitor fetal heart tones
- D. Administer antibiotics
Correct Answer: A
Rationale: Placenta accreta often prevents placental separation leading to severe hemorrhage during delivery which may necessitate hysterectomy. Tocolytics fetal monitoring and antibiotics are not primary interventions for this condition.
The physician has ordered a low-residue diet for a client with Crohn's disease. Which food is not permitted in a low-residue diet?
- A. Mashed potatoes
- B. Smooth peanut butter
- C. Fried fish
- D. Rice
Correct Answer: C
Rationale: A low-residue diet minimizes fiber and irritating foods; fried fish is high in fat and can irritate the gut, making it unsuitable for Crohn's disease.
A client is having episodes of hyperventilation related to her surgery that is scheduled tomorrow. Appropriate nursing actions to help control hyperventilating include:
- A. Administering diazepam (Valium) 10-15 mg po q4h and q1h prn for hyperventilating episode
- B. Keeping the temperature in the client's room at a high level to reduce respiratory stimulation
- C. Having the client hold her breath or breathe into a paper bag when hyperventilation episodes occur
- D. Using distraction to help control the client's hyperventilation episodes
Correct Answer: C
Rationale: An adult diazepam dosage for treatment of anxiety is 2-10 mg PO 2-4 times daily. The order as written would place a client at risk for overdose. A high room temperature could increase hyperventilating episodes by stimulating the respiratory system. Breath holding and breathing into a paper bag may be useful in controlling hyperventilation. Both measures increase CO2 retention. Distraction will not prevent or control hyperventilation caused by anxiety or fear.