Nokea
The mother of a 10-year-old boy with IDDM (insulin-dependent diabetes mellitus) calls to discuss the child’s self-monitoring blood glucose (SMBG) home readings. He is being tightly regulated with a combination of NPH and regular insulin before breakfast and supper. The past two mornings his blood sugar readings were 220 mg/dL and 210 mg/dL. The nurse should advise the mother to
- A. continue with his medication regime.
- B. check his blood sugar during the night.
- C. give his NPH insulin later in the evening.
- D. serve his bedtime snack earlier in the evening.
Correct Answer: B
Rationale: High morning blood sugars suggest rebound hyperglycemia (Somogyi effect) from nocturnal hypoglycemia, requiring nighttime glucose checks. Options A, C, and D are premature: continuing the regimen ignores the issue, and adjusting insulin or snack timing requires confirmation.
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A client receives morphine sulfate after being admitted to the emergency room in acute respiratory distress. He is very anxious, edematous, and cyanotic. Which of the following should the nurse recognize as the desired response to the medication?
- A. Increase in pulse pressure.
- B. Decrease in anxiety.
- C. Depression of the sympathetic nervous system.
- D. Enhanced ventilation and decreased cyanosis.
Correct Answer: B
Rationale: morphine sulfate is administered to minimize anxiety associated with respiratory distress from pulmonary edema
A low-income client needing to satisfy essential protein needs.
Which of the following foods would the nurse encourage a low-income client to eat to satisfy essential protein needs?
- A. Legumes.
- B. Red meat.
- C. Seafood.
- D. Cheese.
Correct Answer: A
Rationale: Strategy: Think about each answer choice. (1) correct-legumes are an economical source rich in protein (2) high in protein, but more expensive to purchase (3) high in protein, but more expensive to purchase (4) high in protein, but more expensive to purchase
An adult is admitted to the unit with a fractured femur and will be in Buck's extension traction for several days. The client tells the nurse that she has all of the following. Which is likely to cause the client the most problems at this time?
- A. High blood pressure
- B. Hiatal hernia
- C. Osteoarthritis of the fingers
- D. High cholesterol
Correct Answer: B
Rationale: Hiatal hernia can be exacerbated by prolonged immobility in traction, increasing reflux and discomfort. Hypertension, finger osteoarthritis, and high cholesterol are less directly impacted by traction.
The nurse is performing discharge teaching for a client with Addison’s disease.
- A. What is the most important instruction for a client with Addison’s disease?
- B. Signs and symptoms of infection.
- C. Fluid and electrolyte balance.
- D. Seizure precautions.
- E. Steroid replacement.
Correct Answer: D
Rationale: Steroid replacement is critical for Addison’s disease to manage adrenal insufficiency and prevent life-threatening crises. Infection, fluid balance, and seizures are secondary concerns compared to ensuring steroid therapy adherence.
Which vitamin is directly involved in the metabolism of the hormones secreted by the parathyroid?
- A. Vitamin C
- B. Vitamin D
- C. Vitamin K
- D. Vitamin B9
Correct Answer: B
Rationale: Vitamin D is critical for calcium absorption, which is regulated by parathyroid hormones. Vitamins C, K, and B9 are not directly involved.