Nokea
The home health nurse is completing the first home visit for the elderly Hispanic client newly diagnosed with type 2 DM. The client has been instructed on self-administering NPH and regular insulin in the morning and at suppertime. What information should the nurse reinforce when teaching the client? Select all that apply.
- A. Inspect the feet and between the toes daily.
- B. Use magnifying devices to read small print.
- C. Perform a hemoglobin A1c test once a week.
- D. Eat a 15-gram carbohydrate snack at bedtime.
- E. Inject 1 unit of NPH insulin after eating a snack
Correct Answer: A,B,D
Rationale: Daily foot inspection prevents complications, magnifying devices prevent dosing errors, and a bedtime snack covers insulin peaks to prevent hypoglycemia.
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The nurse is caring for the client who is experiencing symptoms associated with pheochromocytoma. Which intervention should be included in the plan of care for this client?
- A. Offer distractions such as television or music.
- B. Encourage family and friends to visit often.
- C. Assist with ambulation at least three times a day.
- D. Administer nicardipine for hypertension.
Correct Answer: D
Rationale: Nicardipine controls hypertension caused by excess catecholamines in pheochromocytoma.
When directing the nursing assistant to weigh the client, which instruction is most important for obtaining accurate data?
- A. Have the client stand on a bedside scale.
- B. Weigh the client at the same time each day.
- C. Ask that slippers be removed when being weighed.
- D. Ask about the client's pre-disease weight.
Correct Answer: B
Rationale: Weighing the client at the same time each day ensures consistency and accounts for daily fluctuations in weight due to meals, hydration, or other factors.
Which statement by the client indicates a misunderstanding of the expected surgical outcome?
- A. My appearance will gradually become normal.
- B. I'll need to take replacement hormones.
- C. I'll need to see my physician regularly.
- D. The surgical incision will be inconspicuous.
Correct Answer: A
Rationale: In acromegaly, physical changes such as enlarged hands or facial features are typically irreversible, even after surgery.
The nurse is completing discharge teaching to the client diagnosed with acute pancreatitis. Which instruction should the nurse discuss with the client?
- A. Instruct the client to decrease alcohol intake.
- B. Explain the need to avoid all stress.
- C. Discuss the importance of stopping smoking.
- D. Teach the correct way to take pancreatic enzymes.
Correct Answer: A
Rationale: Decreasing alcohol intake is critical, as alcohol is a major cause of pancreatitis. Stress avoidance is unrealistic, smoking is secondary, and enzymes are for chronic cases.
The client is admitted to the ICU diagnosed with DKA. Which interventions should the nurse implement? Select all that apply.
- A. Maintain adequate ventilation.
- B. Assess fluid volume status.
- C. Administer intravenous potassium.
- D. Check for urinary ketones.
- E. Monitor intake and output.
Correct Answer: A,B,D,E
Rationale: Ventilation, fluid status, ketone checks, and I&O monitoring manage DKA’s acidosis, dehydration, and ketosis. Potassium is given only if low, not routinely.