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The nurse administered 28 units of Humulin N, an intermediate-acting insulin, to a client diagnosed with type 1 diabetes at 1600. Which intervention should the nurse implement?
- A. Ensure the client eats the bedtime snack.
- B. Determine how much food the client ate at lunch.
- C. Perform a glucometer reading at 0700.
- D. Offer the client protein after administering insulin.
Correct Answer: A
Rationale: Humulin N peaks in 4–12 hours, risking nocturnal hypoglycemia. A bedtime snack prevents this. Lunch intake is irrelevant, morning glucose checks are too late, and protein alone is insufficient.
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The client is a 62-year-old woman who is 30 pounds overweight. She comes to the doctor's office complaining of headaches, frequent hunger, excessive thirst, and urination. The presenting complaints suggest that the nurse should assess for other signs of which condition?
- A. Hypothyroidism
- B. Acute pyelonephritis
- C. Addison's disease
- D. Diabetes mellitus
Correct Answer: D
Rationale: Headaches, polyphagia, polydipsia, and polyuria are classic symptoms of diabetes mellitus, especially in an overweight individual.
Which laboratory data indicate to the nurse the client’s pancreatitis is improving?
- A. The amylase and lipase serum levels are decreased.
- B. The white blood cell (WBC) count is decreased.
- C. The conjugated and unconjugated bilirubin levels are decreased.
- D. The blood urea nitrogen (BUN) serum level is decreased.
Correct Answer: A
Rationale: Acute pancreatitis is characterized by elevated serum amylase and lipase levels due to pancreatic inflammation. A decrease in these levels indicates reduced pancreatic injury and improvement in the condition. While a decreased WBC count may suggest resolving infection, it is less specific. Bilirubin levels are relevant for biliary obstruction, not pancreatitis improvement, and BUN reflects renal function, not pancreatic status.
Which question should the nurse ask when assessing the client for an endocrine dysfunction?
- A. Have you noticed any pain in your legs when walking?
- B. Have you had any unexplained weight loss?
- C. Have you noticed any change in your bowel movements?
- D. Have you experienced any joint pain or discomfort?
Correct Answer: B
Rationale: Unexplained weight loss is a hallmark symptom of endocrine disorders like hyperthyroidism or diabetes mellitus, making it a key assessment question. Leg pain relates to vascular issues, bowel changes are less specific, and joint pain is more musculoskeletal.
The nurse is admitting a client to rule out aldosteronism. Which assessment data support the client's diagnosis?
- A. Temperature.
- B. Pulse.
- C. Respirations.
- D. Blood pressure.
Correct Answer: D
Rationale: Elevated blood pressure is a hallmark of aldosteronism due to sodium retention and fluid overload. Temperature, pulse, and respirations are less specific.
Which laboratory test is most important for the nurse to monitor to determine how effectively the client's diabetes is being managed?
- A. Fasting blood glucose
- B. Blood chemistry profile
- C. Complete blood count
- D. Glycosylated hemoglobin (HbA1c)
Correct Answer: D
Rationale: HbA1c reflects average blood glucose control over 2-3 months, indicating long-term diabetes management.