Nokea
The nurse has instructed a client scheduled for an injection of dulaglutide for diabetes mellitus (type two). Which of the following statements by the client would require follow-up?
- A. I should tell my doctor if I experience abdominal pain and vomiting.
- B. I should take this medication within one hour of eating a meal.
- C. If this medication works, I should notice a reduction in my hemoglobin A1C (HbA1c).
- D. I will receive this medication once a week.
Correct Answer: B
Rationale: Dulaglutide, a GLP-1 agonist, is taken weekly regardless of meals, not within one hour of eating. Abdominal pain/vomiting should be reported, HbA1c reduction is expected, and weekly dosing is correct.
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The nurse caring for a diabetes mellitus client obtained a scheduled capillary blood glucose. The result indicated 40 mg/dL (2.22 mmol/L) [70-110 mg/dL, 4.0-11.0 mmol/L]. The client reports no symptoms. The initial action of the nurse should be which of the following?
- A. Document the finding in the medical record
- B. Repeat the capillary blood glucose test to validate the result
- C. Administer 15 grams of a quick-acting carbohydrate
- D. Administer 1 mg of glucagon subcutaneously
Correct Answer: B
Rationale: A glucose of 40 mg/dL is critically low, even without symptoms. Repeating the test validates the result, ensuring accuracy before treatment to avoid unnecessary intervention.
The nurse is caring for a client diagnosed with hyperparathyroidism. Which laboratory data would support this diagnosis?
- A. Potassium 4.1 mEq/L (mmol/L) [3.5-5 mEq/L, mmol/L]
- B. Phosphorus 4.9 mEq/L (mmol/L) [2-4.5 mEq/L, 0.81-1.58 mmol/L]
- C. Calcium 11.2 mg/dL (2.8 mmol/L) [9-10.5 mg/dL, 2.12-2.52 mmol/L]
- D. Sodium 132 mEq/L (mmol/L) [135-145 mEq/L, mmol/L]
Correct Answer: C
Rationale: Hyperparathyroidism increases PTH, raising blood calcium (11.2 mg/dL is elevated) and often lowering phosphorus. Potassium and sodium are not directly affected.
The nurse is caring for a client who has nephrogenic diabetes insipidus. Which of the following medications should the nurse expect to be prescribed for the client?
- A. prednisone
- B. hydrochlorothiazide
- C. verapamil
- D. lithium
Correct Answer: B
Rationale: Nephrogenic diabetes insipidus reduces kidney response to ADH. Hydrochlorothiazide paradoxically reduces urine output by increasing sodium excretion, concentrating urine. Prednisone, verapamil, and lithium are unrelated or worsen DI.
The nurse is assessing a client with a myxedema coma. Which of the following would be an expected finding?
- A. Glucose 59 mg/dL (3.28 mmol/L) [70-110 mg/d, 4.0-6.0 mmol/L]
- B. Sodium 155 mEq/L (mmol/L) [135-145 mEq/L, mmol/L]
- C. Serum pH 7.49 [7.35-7.45]
Correct Answer: A
Rationale: Myxedema coma, a severe hypothyroid state, can cause hypoglycemia due to reduced metabolism. Hypernatremia and alkalosis are not typical; hyponatremia and acidosis are more common.
The nurse is teaching a client prescribed prednisolone. Which of the following information should the nurse include?
- A. Take this medication in the morning with food.
- B. The best time to take this medication is later in the afternoon without food.
- C. This medication before bed with a light snack.
- D. You can take this medication anytime, as long as you take it on an empty stomach.
Correct Answer: A
Rationale: Prednisolone should be taken in the morning with food to align with cortisol rhythms and minimize gastrointestinal upset. Afternoon, bedtime, or empty-stomach dosing increases side effects or reduces efficacy.