Nokea
The client with type 1 diabetes mellitus is being educated by the nurse about the signs of hypoglycemia. Which of the following symptoms should the client be instructed to report immediately?
- A. Shakiness
- B. Sweating
- C. Confusion
- D. Increased thirst
Correct Answer: C
Rationale: Confusion is a critical symptom of hypoglycemia that may indicate a more severe drop in blood glucose levels. Immediate reporting of confusion is crucial as it could progress rapidly to unconsciousness or seizures, necessitating prompt intervention. Shakiness and sweating are common early signs of hypoglycemia but may not require immediate intervention unless other severe symptoms present. Increased thirst is more indicative of hyperglycemia rather than hypoglycemia, and while it should be monitored, it is not a symptom requiring immediate reporting.
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A nurse manager is reviewing data from the unit. More than 50% of new nurses hired left within 1 year of being hired. Which of the following implementations should the nurse manager consider to improve retention of newly hired nurses?
- A. Increase the length of time new hires spend in training.
- B. Conduct a performance review at 3, 6, and 9 months to review the new nurse's weaknesses.
- C. Stress the importance of continuity of care to new hires.
- D. Build the manager's own leadership skills through building relationships with staff members.
Correct Answer: D
Rationale: To improve retention of newly hired nurses, the nurse manager should focus on building their own leadership skills and relationships with staff members. By creating a supportive environment and demonstrating effective leadership, the manager can positively impact staff retention. Options A, B, and C do not directly address the core issue of creating a supportive work environment and effective leadership, which are crucial for retaining newly hired nurses.
A healthcare provider caring for a client with severe malnutrition reviews the laboratory results and notes a magnesium level of 1.0 mg/dL. Which electrocardiographic change would the healthcare provider expect to note based on the magnesium level?
- A. Prominent U waves
- B. Prolonged PR interval
- C. Depressed ST segment
- D. Widened QRS complexes
Correct Answer: C
Rationale: A magnesium level of 1.0 mg/dL can cause a depressed ST segment on the ECG. Magnesium deficiency commonly leads to ST segment depression on an electrocardiogram. Prominent U waves are associated with hypokalemia, prolonged PR interval is seen in conditions like first-degree heart block, and widened QRS complexes are typically related to conditions affecting the conduction system of the heart, such as bundle branch blocks.
The healthcare provider is monitoring a client with diabetic ketoacidosis (DKA). Which of the following laboratory findings would be expected?
- A. Decreased blood glucose levels
- B. Decreased urine ketones
- C. Increased serum bicarbonate
- D. Increased anion gap
Correct Answer: D
Rationale: In diabetic ketoacidosis (DKA), there is an excess of ketone bodies produced due to the breakdown of fatty acids for energy, leading to metabolic acidosis. An increased anion gap is a characteristic laboratory finding in DKA. The increased anion gap is a result of the accumulation of ketoacids and lactic acid in the blood, contributing to metabolic acidosis. Therefore, the correct answer is an increased anion gap. Choices A, B, and C are incorrect because in DKA, blood glucose levels are typically elevated, urine ketones are increased due to the breakdown of fatty acids, and serum bicarbonate is usually decreased as it is consumed in an attempt to buffer the acidosis.
The client with newly diagnosed type 2 diabetes mellitus is being taught about self-care management. Which of the following statements indicates a need for further teaching?
- A. I will rotate my injection sites to prevent skin damage.
- B. I can stop taking my medication if my blood sugar is normal.
- C. I should monitor my blood sugar levels regularly.
- D. I should follow a healthy diet and exercise regularly.
Correct Answer: B
Rationale: The correct answer is B. Clients with type 2 diabetes mellitus should not stop taking their medication even if blood sugar levels are normal. This is because ongoing management is necessary to control blood sugar levels and prevent complications. Choice A is correct as rotating injection sites helps prevent skin damage and improves insulin absorption. Choice C is correct as regular monitoring of blood sugar levels is vital for managing diabetes effectively. Choice D is correct as following a healthy diet and exercising regularly are key components of diabetes management.
A healthcare professional caring for a client who has been receiving intravenous diuretics suspects that the client is experiencing a deficient fluid volume. Which assessment finding would the healthcare professional note in a client with this condition?
- A. Lung congestion
- B. Decreased hematocrit
- C. Increased blood pressure
- D. Decreased central venous pressure (CVP)
Correct Answer: D
Rationale: Decreased central venous pressure (CVP) is the correct assessment finding in a client with deficient fluid volume. This is because a decrease in CVP indicates reduced blood volume returning to the heart, which is consistent with hypovolemia. Lung congestion (Choice A) would be more indicative of fluid volume excess, not deficiency. Decreased hematocrit (Choice B) may be seen in conditions such as anemia but is not specific to deficient fluid volume. Increased blood pressure (Choice C) is not typically associated with deficient fluid volume; in fact, hypovolemia often leads to decreased blood pressure.