Nokea
The diabetic educator is teaching a class on diabetes type 1 and is discussing sick-day rules. Which interventions should the diabetes educator include in the discussion? Select all that apply.
- A. Take diabetic medication even if unable to eat the client's normal diabetic diet.
- B. If unable to eat, drink liquids equal to the client's normal caloric intake.
- C. It is not necessary to notify the health-care provider (HCP) if ketones are in the urine.
- D. Test blood glucose levels and test urine ketones once a day and keep a record.
- E. Call the health-care provider if glucose levels are higher than 180 mg/dL.
Correct Answer: A,B
Rationale: Continuing insulin and consuming caloric liquids (e.g., juice) prevent DKA during illness. Ketones require HCP notification, daily testing is insufficient, and 180 mg/dL is too low for notification.
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The nurse knows the diabetic client understands what 'free' foods on the exchange list means if the client excludes which one of the following from a meal plan?
- A. Iced tea
- B. Flavored water
- C. Light beer
- D. Club soda
Correct Answer: C
Rationale: Light beer contains carbohydrates and calories, unlike free foods such as iced tea, flavored water, and club soda.
The nurse teaches the client with newly diagnosed diabetes mellitus about the signs and symptoms of hypoglycemia. Which of the following should the nurse stress in teaching? Select all that apply.
- A. Sleepiness
- B. Shallow
- C. Thirst
- D. Hunger
- E. Diaphoresis
- F. Confusion
Correct Answer: D,E,F
Rationale: Hypoglycemia causes hunger, diaphoresis, and confusion due to low blood glucose affecting the brain and body.
Postoperatively, the nurse should consult the physician before encouraging the client who has undergone a subtotal thyroidectomy to perform which activity?
- A. Forced coughing
- B. Decompelling
- C. Ambulating
- D. Dangling legs
Correct Answer: A
Rationale: Forced coughing can increase pressure in the neck, risking bleeding or wound disruption post-thyroidectomy.
The client newly diagnosed with hyperthyroidism has a fever of 101.3°F (38.5°C). Which additional assessment findings should the nurse identify as those associated with thyroid storm? Select all that apply.
- A. Hypoventilation
- B. Heart rate 140 bpm
- C. Diarrhea last 4 days
- D. Periorbital edema
- E. Recent tooth extraction
Correct Answer: B,C,E
Rationale: Tachycardia, diarrhea, and recent stress (e.g., tooth extraction) are associated with thyroid storm due to excessive thyroid hormone.
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.