Nokea
The clinic nurse is evaluating the client with type 1 DM who intends to enroll in a tennis class. Which statement made by the client indicates that the client understands the effects of exercise on insulin demand?
- A. I will carry a high-fat, high-calorie food, such as a cookie.'
- B. I will administer 1 unit of lispro insulin prior to playing tennis.'
- C. I will eat a 15-gram carbohydrate snack before playing tennis.'
- D. I will need to rest for a while during tennis if I feel sweaty or shaky.'
Correct Answer: C
Rationale: Excessive exercise without sufficient carbohydrates can result in unexpected hypoglycemia.
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An elderly client with Type 2 diabetes mellitus develops an ingrown toenail. What is the best action for the nurse to take?
- A. Put cotton under the nail and clip the nail straight across
- B. Elevate the foot immediately
- C. Apply warm, moist soaks
- D. Notify the physician
Correct Answer: D
Rationale: An ingrown toenail in a diabetic client risks infection and poor healing, requiring physician evaluation rather than self-treatment.
Which statement provides the best evidence that the client understands the prescribed drug therapy?
- A. I must take this drug after meals.
- B. I'll need to take this drug life-long.
- C. I can skip a dose if I'm nauseated.
Correct Answer: B
Rationale: Levothyroxine for myxedema typically requires lifelong therapy to maintain thyroid hormone levels.
The client with type 2 DM is scheduled for cardiac rehabilitation exercises (cardiac rehab). The nurse notes that the client's blood glucose level is 300 mg/dL and that the urine is positive for ketones. How should the nurse proceed?
- A. Send the client to cardiac rehab; exercise will lower the client's glucose level.
- B. Give insulin; send the client for exercises with a 15-gram carbohydrate snack.
- C. Delay cardiac rehab; blood glucose levels will decrease too much with exercise.
- D. Cancel cardiac rehab; blood glucose levels will increase further with exercise.
Correct Answer: D
Rationale: Exercising with blood glucose levels exceeding 250 mg/dL and ketonuria increases the secretion of glucagon, growth hormone, and catecholamines, causing the liver to release more glucose.
The nurse teaches the client how the infusion pump operates and correctly points out that the infusion is typically administered in which location?
- A. In a vein within the nondominant hand
- B. In the muscular tissue of the thigh
- C. In the subcutaneous tissue of the abdomen below the belt line
- D. In an implanted I.V. catheter threaded into the neck
Correct Answer: C
Rationale: Insulin pumps deliver insulin into the subcutaneous tissue of the abdomen for consistent absorption.
The client with an acute exacerbation of chronic pancreatitis has a nasogastric (N/G) tube. Which interventions should the nurse implement? Select all that apply.
- A. Monitor the client's bowel sounds.
- B. Monitor the client's food intake.
- C. Assess the client's intravenous site.
- D. Provide oral and nasal care.
- E. Monitor the client's blood glucose.
Correct Answer: A,C,D,E
Rationale: Monitoring bowel sounds, IV site, oral/nasal care, and glucose manage NG tube complications and pancreatitis-related risks (e.g., hyperglycemia). Food intake is irrelevant with NPO status.