Nokea
The nurse has instructed a client with diabetes mellitus (type 1) about proper exercise. Which of the following statements by the client would indicate a correct understanding of the teaching?
- A. I should carry a snack rich in protein just in case I feel shaky.
- B. I will not take my prescribed daily glargine insulin if I plan on exercising.
- C. I can initially expect my glucose level to rise with vigorous exercise, but if I continue exercising, my levels may eventually decrease.
- D. I should start my exercise near the time that my insulin peaks.
Correct Answer: C
Rationale: Vigorous exercise can initially raise blood glucose due to stress hormones, but prolonged activity increases glucose uptake by muscles, lowering levels. Carrying a carbohydrate-rich snack, not protein, is best for hypoglycemia. Insulin should never be skipped, and exercising at peak insulin time risks hypoglycemia.
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The nurse is teaching a client about newly prescribed insulin glargine. The nurse recognizes the need for further instruction when the client makes the following statement?
- A. I will take this insulin right before my meals.
- B. I should roll this vial of insulin before removing it with the syringe.
- C. This insulin will help control my glucose for 24 hours.
- D. I can only inject this insulin into my abdomen.
- E. I'm glad to know I can mix this with my regular insulin.
Correct Answer: A,B,D,E
Rationale: Insulin glargine is a long-acting insulin taken once daily, not before meals, provides 24-hour coverage, and should not be mixed with other insulins. It is clear and does not require rolling, and can be injected in multiple sites, not just the abdomen. Only the statement about 24-hour control is correct.
The nurse is caring for a client immediately following transsphenoidal hypophysectomy. It would be essential for the nurse to obtain a prescription for which medication?
- A. Ondansetron
- B. Methimazole
- C. Omeprazole
- D. Methylphenidate
Correct Answer: A
Rationale: Transsphenoidal hypophysectomy often causes nausea from surgical manipulation near the pituitary. Ondansetron controls postoperative nausea. Methimazole is for hyperthyroidism, omeprazole for gastric issues, and methylphenidate for attention disorders.
The nurse is caring for a client with a confirmed pregnancy in her first trimester with hyperthyroidism. The nurse anticipates the physician will prescribe
- A. levothyroxine
- B. calcitriol
- C. methimazole
- D. propylthiouracil (PTU)
Correct Answer: D
Rationale: Propylthiouracil (PTU) is preferred in the first trimester of pregnancy for hyperthyroidism due to lower teratogenic risk compared to methimazole. Levothyroxine treats hypothyroidism, and calcitriol manages calcium levels.
The following scenario applies to the next 1 items
The nurse in physician's office is caring for a 41-year-old male
Item 1 of 1
Nurses' Notes
1100 - Client presents for a routine follow-up and a medication refill. Client has no acute concerns and reports full adherence to his prescribed medications. Vital signs: T 97.5° F (36.4° C), P 90, RR 18, BP 138/88, pulse oximetry reading 96% on room air.
Medical History
• diabetes mellitus (type 2)
• hyperlipidemia
• hypertension
• irritable bowel syndrome
Current Medications
• metformin 1 gram by mouth daily
• glipizide 5 mg by mouth daily, before breakfast
• lisinopril 40 mg by mouth daily
• multivitamin 1 tablet by mouth daily
• atorvastatin 80 mg by mouth daily
The nurse reviews the client's medical record. Please complete the sentence below from the list of options. Based on the August glycated hemoglobin A1C results the client is
- A. going to require a prescription for insulin.
- B. having frequent episodes of hyperglycemia.
- C. demonstrating evidence of good glucose control.
- D. None of the above
Correct Answer: C
Rationale: Without specific HbA1C results, stable type 2 diabetes with adherence to metformin and glipizide suggests good control, assuming prior results were within target (<7%).
The nurse reviews laboratory data for a client with suspected diabetes mellitus (DM). Which action should the nurse take based on the client's hemoglobin A1C? See Exhibit.
- A. assess the client for an infection
- B. instruct the client that the results are within normal limits
- C. assess the client's urine for glycosuria
- D. educate the client on a diet with low-glycemic foods
Correct Answer: D
Rationale: Without specific HbA1C values, a suspected DM diagnosis warrants dietary education on low-glycemic foods to manage blood sugar. Infection or glycosuria assessment depends on results, and normal limits are unlikely if DM is suspected.