Nokea
The nurse in the outpatient clinic is caring for assigned clients with type 1 diabetes mellitus. Which client should the nurse recognize as having the highest risk of developing hypoglycemia?
- A. 29-year-old client with new-onset influenza
- B. 40-year-old client who is a cyclist and is training for an upcoming race
- C. 65-year-old client with cellulitis of the right leg
- D. 72-year-old client with emphysema who is receiving prednisone
Correct Answer: D
Rationale: Prednisone increases blood glucose, but abrupt cessation or dose changes can cause hypoglycemia in type 1 diabetes due to insulin sensitivity. Influenza, exercise, and cellulitis pose risks, but prednisone’s metabolic impact is greatest.
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An adult is being discharged on a low-sodium, low-fat diet. Which menu, if selected by the client, indicates an understanding of the diet?
- A. Hamburger with fries, apple pie, milkshake
- B. Tossed salad with vinaigrette dressing, baked skinny chicken, applesauce
- C. Steak, corn on the cob, fruit salad
- D. Fried shrimp, coleslaw, strawberry shortcake
Correct Answer: B
Rationale: Tossed salad, baked skinless chicken, and applesauce are low in sodium and fat, aligning with the prescribed diet.
The nurse is reinforcing teaching about oral hydrocortisone for a client with newly diagnosed primary adrenal insufficiency (i.e., Addison disease). Which of the following information should the nurse reinforce? Select all that apply.
- A. Discontinue hydrocortisone if you have mood changes or disruptions in behavior
- B. Report even a low-grade fever to the health care provider immediately
- C. Report signs of hyperglycemia, including increased urine, hunger, and thirst
- D. The dose of hydrocortisone may need to be increased during times of illness or injury
- E. This medication should be taken on an empty stomach to enhance absorption
Correct Answer: B,C,D
Rationale: Reporting fever, hyperglycemia, and adjusting doses during illness are critical for Addison disease management. Hydrocortisone should not be stopped abruptly, and food enhances absorption.
What information would be most important for the nurse to obtain from a client with suspected bladder cancer who reports blood in the urine but no associated pain?
- A. Family history
- B. Industrial chemical exposure
- C. Tobacco use
- D. Usual diet
Correct Answer: C
Rationale: Tobacco use is the strongest risk factor for bladder cancer, strongly linked to painless hematuria. Chemical exposure is relevant but less common, family history is weak, and diet is not a primary factor.
Which of the following is a common complaint of the client with end-stage renal failure?
- A. Weight loss
- B. Itching
- C. Ringing in the ears
- D. Bruising
Correct Answer: B
Rationale: Itching is common in end-stage renal failure due to uremia and phosphate accumulation. Weight loss , tinnitus , and bruising are less specific.
The nurse has taught the parent of a 6-year-old client with bacterial conjunctivitis how to administer ophthalmic medications. Which of the following statements by the parent would indicate a correct understanding of the teaching?
- A. My child should look down at the floor while I administer the eye drops.
- B. My child should squeeze the eyes closed after I administer the eye drops.
- C. I will apply firm pressure to my child's eyes after I administer the eye ointment
- D. I will apply the eye ointment along my child's lower eyelids starting at the inner corner of the eyes
Correct Answer: D
Rationale: Appropriate administration of ophthalmic medications (eg, eye drops, ointments) protects eye structures and ensures appropriate distribution across the eye. Ophthalmic ointment should be administered along the lower eyelid, moving from the inner canthus to the outer canthus (inner corner to outer corner) (Option 4). In addition, the medication package (eg, eye dropper, tube of ointment) must not touch the eyes to prevent contamination.