Nokea
The client with type 2 DM is receiving dietary instructions from the nurse regarding the prescribed diabetic diet. The nurse determines that the client understands the instructions if the client states that:
- A. I need to skip meals if my blood glucose level is elevated.
- B. I need to eat a small meal or snack every 2 to 3 hours.
- C. I need to avoid using concentrated sweets in my diet.
- D. I need to eat a high-protein, low-carbohydrate diet.
Correct Answer: C
Rationale: The correct answer is C: 'I need to avoid using concentrated sweets in my diet.' Clients with type 2 diabetes should avoid concentrated sweets as they can cause rapid spikes in blood glucose levels, which can be detrimental to their health. Option A is incorrect because skipping meals can lead to fluctuations in blood glucose levels. Option B is incorrect as it does not address the specific issue of avoiding concentrated sweets. Option D is incorrect because a high-protein, low-carbohydrate diet is not typically recommended as the primary approach for managing type 2 diabetes.
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The client has been vomiting and has had numerous episodes of diarrhea. Which laboratory test should the nurse monitor?
- A. Serum calcium.
- B. Serum phosphorus.
- C. Serum potassium.
- D. Serum sodium.
Correct Answer: C
Rationale: During episodes of vomiting and diarrhea, there is a risk of significant potassium loss, leading to potential electrolyte imbalances. Monitoring serum potassium levels is crucial in this situation to assess and manage any abnormalities promptly. Serum calcium (Choice A) is not typically affected by vomiting and diarrhea. Serum phosphorus (Choice B) levels are not commonly altered by these symptoms. Serum sodium (Choice D) may be affected in severe cases of dehydration, but potassium monitoring is a higher priority due to its potential for rapid depletion in vomiting and diarrhea.
Which of the following is an interpersonal activity of nurse managers, but not necessarily all nurse leaders?
- A. Coaching
- B. Resource allocation
- C. Planning for the future
- D. Monitoring
Correct Answer: A
Rationale: The correct answer is A: Coaching. Nurse managers are directly involved in coaching their team members, providing guidance, support, and mentorship. This is a key interpersonal activity that focuses on developing the skills and performance of individual team members. While nurse leaders may also engage in coaching activities, it is a more specific and hands-on role for nurse managers. Choice B, resource allocation, is a managerial function that involves distributing resources effectively and efficiently. Choice C, planning for the future, is a strategic activity that involves setting goals and directions for the organization. Choice D, monitoring, is a supervisory task that involves overseeing and evaluating processes and outcomes. These activities are important for nurse leaders as well as nurse managers, but coaching is a more direct interpersonal interaction typically associated with nurse managers.
A new unit manager works hard to get to know each of the staff members on the unit and determine what each staff member needs in order to effectively do their job. What type of management best describes this manager?
- A. Servant leader-style manager
- B. Networking manager
- C. Coaching manager
- D. Monitoring manager
Correct Answer: A
Rationale: A Servant leader-style manager focuses on understanding and meeting the needs of staff members to help them grow and perform at their best. This type of manager prioritizes serving the team and facilitating their development. Networking managers focus on building connections and relationships outside the team. Coaching managers provide guidance, support, and feedback to help employees improve. Monitoring managers primarily oversee and supervise tasks without a strong emphasis on individual needs or growth.
What clinical feature distinguishes a hypoglycemic reaction from a ketoacidosis reaction?
- A. Blurred vision.
- B. Diaphoresis.
- C. Nausea.
- D. Weakness.
Correct Answer: B
Rationale: Diaphoresis is the correct answer because it is more characteristic of hypoglycemia. Hypoglycemia typically presents with symptoms such as diaphoresis (excessive sweating), palpitations, tremors, and anxiety. On the other hand, ketoacidosis is associated with symptoms such as fruity breath, deep and labored breathing (Kussmaul respirations), nausea, vomiting, and abdominal pain. Blurred vision can occur in both hypoglycemia and ketoacidosis due to metabolic disturbances affecting the eyes. Weakness is a nonspecific symptom that can be present in both conditions, making it less helpful in distinguishing between the two.
Jemma, who weighs 210 lb (95 kg) and has been diagnosed with hyperglycemia tells the nurse that her husband sleeps in another room because her snoring keeps him awake. The nurse notices that she has large hands and a hoarse voice. Which of the following would the nurse suspect as a possible cause of the client's hyperglycemia?
- A. Acromegaly
- B. Type 1 diabetes mellitus
- C. Hypothyroidism
- D. Deficient growth hormone
Correct Answer: A
Rationale: The correct answer is Acromegaly. Jemma's symptoms of large hands, hoarse voice, and snoring are indicative of acromegaly, a disorder caused by excessive growth hormone production. Acromegaly can lead to insulin resistance, which can result in hyperglycemia. Choice B, Type 1 diabetes mellitus, is unlikely in this case as the symptoms and presentation are more suggestive of acromegaly. Choice C, Hypothyroidism, typically presents with different symptoms such as weight gain, fatigue, and cold intolerance, not consistent with Jemma's symptoms. Choice D, Deficient growth hormone, would not lead to the signs and symptoms observed in Jemma, as her condition is characterized by excessive growth hormone production.