Nokea
The nurse has provided education to a client newly prescribed glipizide. Which of the following statements by the client would indicate a correct understanding of the teaching?
- A. I will need to take this medication 30 minutes before a meal.
- B. I can expect to lose weight while taking this medication.
- C. I should not take this medication if I had a procedure involving contrast dye.
- D. This medication may cause me to develop vitamin B12 deficiency.
Correct Answer: A
Rationale: Glipizide, a sulfonylurea, should be taken 30 minutes before meals to enhance insulin secretion during eating. It may cause weight gain, not loss, and is not affected by contrast dye or linked to B12 deficiency.
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The nurse assesses clients for the risk of developing hyperosmolar hyperglycemic syndrome. Which of the following clients should the nurse consider to be at greatest risk?
- A. 63-year-old with diabetes mellitus (type two) who works outdoors and recently had an increased dosage of metformin.
- B. 55-year-old with diabetes mellitus (type one) who was recently hospitalized for pneumonia and occasionally forgets to take their long-acting insulin.
- C. 15-year-old with diabetes mellitus (type one) who has a hemoglobin A1C of 7.6% [ < 7%] and has gained 4 lbs (1.8 kg) in the past month.
- D. 45-year-old who was recently diagnosed with diabetes mellitus (type two) and was prescribed glipizide in addition to metformin.
Correct Answer: A
Rationale: HHS is common in type 2 diabetes, especially in older adults. Outdoor work risks dehydration, and increased metformin may not control severe hyperglycemia, heightening HHS risk.
The nurse is assessing a client with hypothyroidism. Which of the following assessment findings would be expected?
- A. Decreased libido
- B. Bradycardia
- C. Heat intolerance
- D. Fatigue
- E. Constipation
Correct Answer: A, B, D, E
Rationale: Hypothyroidism slows metabolism, leading to decreased libido, bradycardia, fatigue, and constipation. Heat intolerance is associated with hyperthyroidism, not hypothyroidism.
The nurse is caring for a client who presents with hyperglycemia. Which of the following findings are expected?
- A. Blurred vision
- B. Increased urinary output
- C. Cool and clammy skin
- D. Tachycardia
- E. Orthostatic hypotension
Correct Answer: A, B, D
Rationale: Hyperglycemia causes blurred vision (osmotic lens changes), increased urination (osmotic diuresis), and tachycardia (dehydration response). Cool, clammy skin is typical of hypoglycemia, and orthostatic hypotension is less specific.
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 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.