Nokea
The client had a total pancreatectomy and splenectomy for cancer of the body of the pancreas. Which discharge instructions should the nurse teach? Select all that apply.
- A. Keep a careful record of intake and output.
- B. Use a stool softener or bulk laxative regularly.
- C. Use correct insulin injection technique.
- D. Take the pain medication before the pain gets too bad.
- E. Sleep with the head of the bed on blocks.
Correct Answer: B,C,D
Rationale: Stool softeners prevent constipation, insulin technique manages post-pancreatectomy diabetes, and proactive pain medication controls discomfort. I&O and elevated bed are unnecessary.
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The nurse's next door neighbor calls. He says he cannot awaken his 21-year-old wife. The nurse notes that the client is unconscious and is having deep respirations. Her breath has a fruity smell to it. The husband says that his wife has been eating and drinking a lot recently and that last night she vomited before lying down. What is the most appropriate action for the nurse to take?
- A. Start cardiopulmonary resuscitation
- B. Get her to a hospital immediately
- C. Try to rouse her by giving her coffee
- D. Give her sweetened orange juice
Correct Answer: B
Rationale: Fruity breath, unconsciousness, and symptoms of polyphagia, polydipsia, and vomiting suggest diabetic ketoacidosis, requiring immediate hospital care.
A woman with newly diagnosed Type I diabetes mellitus says she wants to have children. She asks if she will be able to have children and if they will be normal. What is the best answer for the nurse to give?
- A. Women with diabetes should not get pregnant because it is very difficult to control diabetes during pregnancy.'
- B. Babies born to diabetic mothers are very apt to have severe and noncorrectable birth defects.'
- C. You should be able to safely have a baby if you go to your doctor regularly during pregnancy.'
- D. You should consult carefully with a geneticist before getting pregnant to determine how to prevent your baby from developing diabetes.'
Correct Answer: C
Rationale: With regular medical care, women with Type 1 diabetes can have safe pregnancies, minimizing risks to the baby.
Which instruction by the nurse concerning the test procedure is most accurate?
- A. You need to eat a large meal just before the test.
- B. You can drink coffee or tea in the morning before the test.
- C. You will be given a sweetened drink before the test.
Correct Answer: C
Rationale: A glucose tolerance test involves administering a sweetened drink to assess the body's response to glucose.
When developing the client's care plan, which intervention is most appropriate to add?
- A. Encourage the client to use an electric razor.
- B. Tell the client to file rather than cut toenails.
- C. Make sure that the client receives mouth care twice per day.
- D. Advise the client to use deodorant soap when bathing.
Correct Answer: B
Rationale: Filing toenails prevents injury and infection in diabetic clients with poor healing.
Which finding indicates a potential complication of thyroid crisis that the nurse should prioritize?
- A. Heart rate of 140 beats per minute
- B. Blood pressure of 120/80 mmHg
- C. Temperature of 98.6°F
- D. Respiratory rate of 16 breaths per minute
Correct Answer: A
Rationale: A heart rate of 140 beats per minute indicates severe tachycardia, a life-threatening complication of thyroid crisis requiring immediate intervention.