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The client is a 62-year-old woman who is 30 pounds overweight. She comes to the doctor's office complaining of headaches, frequent hunger, excessive thirst, and urination. The presenting complaints suggest that the nurse should assess for other signs of which condition?
- A. Hypothyroidism
- B. Acute pyelonephritis
- C. Addison's disease
- D. Diabetes mellitus
Correct Answer: D
Rationale: Headaches, polyphagia, polydipsia, and polyuria are classic symptoms of diabetes mellitus, especially in an overweight individual.
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The nurse is admitting a client to rule out aldosteronism. Which assessment data support the client's diagnosis?
- A. Temperature.
- B. Pulse.
- C. Respirations.
- D. Blood pressure.
Correct Answer: D
Rationale: Elevated blood pressure is a hallmark of aldosteronism due to sodium retention and fluid overload. Temperature, pulse, and respirations are less specific.
The client with type 1 DM is scheduled for major surgery in the morning. The nurse on the night shift observes that the client's daily insulin dose remains the same as previously given. Which nursing action is most appropriate?
- A. Notify the prescribing HCP about the client's surgery and ask about any insulin changes.
- B. Write an order to decrease the morning insulin dose by one-half of the prescribed dose.
- C. Do nothing; the HCP would want the client to receive the usual insulin dose prior to surgery.
- D. Have the day shift nurse check a morning glucose level and, if normal, hold the insulin dose.
Correct Answer: A
Rationale: Because the client will be NPO for surgery, the nurse should verify the insulin type and dose to be administered to prevent a hypoglycemic reaction.
Because propylthiouracil (Propyl-Thyracil) can cause agranulocytosis, the nurse advises the client to notify the physician's health problem occurs?
- A. Persistent sore throat
- B. Occasional heart palpitations
- C. Fatigue on exertion
- D. Prolonged bleeding with trauma
Correct Answer: A
Rationale: Agranulocytosis, a side effect of propylthiouracil, can manifest as a persistent sore throat due to decreased white blood cells.
Which statement indicates that the client has misunderstood the nurse's teaching?
- A. I may need more insulin during times of stress.
- B. I may need more food when exercising strenuously.
- C. My insulin needs may change as I get older.
- D. My dependence on insulin may stop eventually.
Correct Answer: D
Rationale: Type 1 diabetes requires lifelong insulin therapy, so dependence will not stop.
Which action by the nurse provides the best data for monitoring the client's therapeutic response to sodium restriction?
- A. Monitoring sodium intake
- B. Measuring pedal edema
- C. Assessing skin turgor
- D. Weighing the client
Correct Answer: B
Rationale: Measuring pedal edema assesses fluid retention, a key indicator of sodium restriction response in Cushing's syndrome.