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The nurse is assessing a client with adrenal crisis. Which of the following findings would be consistent with a diagnosis of adrenal crisis?
- A. bradycardia
- B. hyponatremia
- C. hypertension
- D. pulse deficit
Correct Answer: B
Rationale: Adrenal crisis causes cortisol and aldosterone deficiency, leading to hyponatremia from sodium loss. Bradycardia, hypertension, and pulse deficit are not typical; tachycardia and hypotension are more common.
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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.
The nurse is caring for a client newly diagnosed with diabetic nephropathy. The nurse anticipates a prescription for which medication?
- A. Ciprofloxacin
- B. Enalapril
- C. Sevelamer
- D. Epoetin alfa
Correct Answer: B
Rationale: Enalapril, an ACE inhibitor, slows diabetic nephropathy progression by reducing intraglomerular pressure. Ciprofloxacin treats infections, sevelamer manages hyperphosphatemia, and epoetin alfa treats anemia, none of which are primary for nephropathy.
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 evaluating a client taking levothyroxine for hypothyroidism. Which findings indicate that the client is experiencing an adverse effect?
- A. Heat intolerance
- B. Palpitations
- C. Bradycardia
- D. Constipation
- E. Insomnia
- F. Weight gain
Correct Answer: A,B,E
Rationale: Heat intolerance, palpitations, and insomnia indicate hyperthyroidism, suggesting levothyroxine overdose. Bradycardia, constipation, and weight gain are hypothyroidism symptoms, not adverse effects of levothyroxine.
The nurse is caring for a client newly diagnosed with Cushing's disease. Which of the following client statements requires follow-up?
- A. I will need to eat more potassium-rich foods.
- B. I will need more steroids during periods of stress.
- C. I will be at a higher risk for an infection.
- D. I should do weight-bearing exercises.
Correct Answer: A
Rationale: Cushing's causes hyperkalemia, so more potassium-rich foods are harmful and need follow-up. Extra steroids for stress, infection risk, and weight-bearing exercises are appropriate.