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The client with diabetes mellitus says, 'If I could just avoid what you call carbohydrates in my diet, I guess I would be okay.' The nurse should base the response to this comment on the knowledge that diabetes affects metabolism of which of the following?
- A. Carbohydrates only.
- B. Fats and carbohydrates only.
- C. Protein and carbohydrates only.
- D. Proteins, fats, and carbohydrates.
Correct Answer: D
Rationale: Diabetes affects the metabolism of carbohydrates, proteins, and fats due to insulin's role in regulating all three macronutrients.
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The nurse is planning a home visit for a client with hepatitis. In order to prevent transmission the nurse should focus teaching on:
- A. Proper food handling.
- B. Insulin syringe disposal.
- C. Alpha-interferon.
- D. Use of condoms.
Correct Answer: D
Rationale: Hepatitis B and C are transmitted via body fluids, so condom use (D) prevents sexual transmission. Food handling (A) is more relevant for hepatitis A. Syringe disposal (B) applies to needle-sharing risks, and alpha-interferon (C) is treatment, not prevention.
A client who has been diagnosed with peripheral vascular disease (PVD) is being discharged. The client needs further instruction if she says she will:
- A. Avoid heating pads
- B. Not cross her legs
- C. Wear leather shoes
- D. Use iodine on an injured site
Correct Answer: D
Rationale: Using iodine on an injured site is incorrect, as it can be cytotoxic and impair wound healing in PVD, where tissue perfusion is already compromised. Avoiding heating pads (risk of burns), not crossing legs (improves circulation), and wearing leather shoes (protects feet) are appropriate self-care measures.
When developing a discharge plan to manage the care of a client with chronic obstructive pulmonary disease (COPD), the nurse should advise the client to expect to:
- A. Develop respiratory infections easily.
- B. Maintain current status.
- C. Require less supplemental oxygen.
- D. Show permanent improvement.
Correct Answer: A
Rationale: COPD clients are prone to respiratory infections due to impaired lung defenses. Maintaining status is possible but not an expectation. Oxygen needs may increase, and COPD is progressive, not permanently improved.
The nurse is providing education to a client who is prescribed terbinafine for onychomycosis affecting the toenails. Which statements by the client demonstrate understanding regarding the teaching about terbinafine? Select all that apply.
- A. Following a successful course of treatment, my chance of getting cured is 90%.
- B. I will have to take terbinafine for 3 to 6 months.
- C. I will need liver function tests before starting terbinafine.
- D. I will take this on an empty stomach to help improve its absorption.
- E. It may cause taste or vision changes, so I will report vision changes to my doctor.
- F. Dark urine, pale stools, and persistent nausea may indicate a serious side effect.
Correct Answer: B,C,E
Rationale: Choice B is correct; terbinafine treatment for toenail onychomycosis typically lasts 3-6 months. Choice C is correct; liver function tests are required before and during treatment due to the risk of hepatotoxicity. Choice E is correct; terbinafine can cause taste or vision changes, and vision changes should be reported. Choice A is incorrect; the cure rate is approximately 70-80%, not 90%. Choice D is incorrect; terbinafine can be taken with or without food, and an empty stomach is not required. Choice F is correct; dark urine, pale stools, and nausea may indicate liver toxicity, a serious side effect.
The nurse is applying a hand mitt restraint for a client with pruritis (see fi gure). The nurse should first:
- A. Verify the physician order to use the restraint.
- B. Secure the mitt with ties around the wrist tied to the bed frame.
- C. Place a folded pillow under the wrist.
- D. Place the mitt on top of the hand.
Correct Answer: A
Rationale: Before using any restraints, the nurse must verify that a physician has written an order for the restraint. The mitt does not need to be secured with ties. The client can move the hand as needed. It is not necessary to place a pillow under the wrist. The nurse should place the mitt on the palmer surface of the hand.