Nokea
The nurse is caring for a client newly diagnosed with diabetes mellitus (type one). It would be essential to educate the client to
- A. check their hemoglobin A1C level every three months.
- B. rotate injection sites for insulin administration.
- C. examine their feet with a mirror daily.
- D. recognize the symptoms of hypoglycemia.
Correct Answer: A, B, C, D
Rationale: HbA1C monitors control, rotation prevents lipohypertrophy, foot checks prevent ulcers, and recognizing hypoglycemia symptoms ensures timely treatment in type 1 diabetes.
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The nurse is educating a group of students on the effects of corticosteroids. It would be appropriate for the nurse to identify the following adverse effects associated with corticosteroids.
- A. Mood lability
- B. Immunosuppression
- C. Hypoglycemia
- D. Hyperkalemia
- E. Weight gain
Correct Answer: A, B, E
Rationale: Corticosteroids cause mood changes, suppress immunity, and promote weight gain via fluid retention and fat redistribution. They cause hyperglycemia, not hypoglycemia, and hypokalemia, not hyperkalemia.
The nurse has provided medication instruction to a client who has been prescribed metformin. Which of the following statements, if made by the client, would indicate a correct understanding of the teaching?
- A. This medication may cause me to have bloating or loose stools.
- B. I will need to take my blood glucose prior to taking this medication.
- C. If I eat fewer carbohydrates in a day, I should skip a dose.
- D. The goal of this medication is to increase my hemoglobin A1C.
Correct Answer: A
Rationale: Metformin commonly causes gastrointestinal side effects like bloating or loose stools. Blood glucose checks are not required before dosing, skipping doses is inappropriate, and metformin aims to lower, not increase, HbA1c.
The nurse is preparing a presentation on Cushing's disease. It would be correct if the nurse states that Cushing's disease is caused by
- A. destruction to pancreatic beta cells.
- B. excessive discharge of thyroid-stimulating hormone (TSH).
- C. decrease in the secretion of androgens and glucocorticoids.
- D. increase in the secretion of adrenocorticotropin hormone (ACTH).
Correct Answer: D
Rationale: Cushing's disease results from excess ACTH from the pituitary, overstimulating cortisol production. Beta cell destruction, TSH, and decreased androgens/glucocorticoids are unrelated.
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 teaching a client about diabetes mellitus (type one) and exercise. NWhich statement, if made by the nurse, would be appropriate?
- A. Increasing exercise would increase insulin requirements
- B. Increasing exercise would decrease insulin requirements
- C. Insulin needs do not change with exercise
- D. Decreasing exercise would decrease insulin requirements
Correct Answer: B
Rationale: In type 1 diabetes, exercise increases glucose uptake by muscles, lowering blood sugar and thus decreasing insulin needs. Increased or decreased exercise adjusts insulin in the opposite direction.