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The nurse is caring for a client suspected of having an endocrine disorder. Based on the client's laboratory data, the nurse is at the highest risk for which condition? See the exhibit.
- A. syndrome of inappropriate antidiuretic hormone (SIADH)
- B. diabetes insipidus (DI)
- C. cushing's syndrome/disease
- D. adrenal insufficiency
Correct Answer: C
Rationale: Without specific lab data, Cushing's is a common suspect in endocrine disorders with weight gain, hyperglycemia, and hypertension. SIADH, DI, and adrenal insufficiency require specific lab patterns (e.g., sodium, urine output).
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This nurse is caring for a client who is receiving prescribed sitagliptin. The nurse understands that this medication is intended to treat which condition?
- A. Hyperlipidemia
- B. Diabetes mellitus
- C. Hypothyroidism
- D. Hypertension
Correct Answer: B
Rationale: Sitagliptin, a DPP-4 inhibitor, treats type 2 diabetes mellitus by enhancing incretin effects to lower blood glucose. It does not treat hyperlipidemia, hypothyroidism, or hypertension.
The following scenario applies to the next 1 items
The home health nurse visits a client with chronic diabetes insipidus
Item 1 of 1
Nurses’ Note
1415 – Home health visit completed because the client was admitted to the hospital twice in the past six weeks for treatment nonadherence related to diabetes insipidus. Extensive teaching provided and reviewed education on prescribed desmopressin intranasal, maintenance of fluids, daily weight, intake and output, and when to seek emergency care.
Which client statements would indicate a correct understanding of the teaching?
- A. I should limit the amount of fluids that I drink after 5:00 PM.
- B. I will need to weigh myself at the same time every day.
- C. I should put both doses of the desmopressin in one nostril.
- D. I need to keep a log of my fluid intake and urine output.
- E. I may need an additional dose if I keep urinating a lot.
- F. If I develop confusion with this medication, I should call 911.
Correct Answer: B, D, F
Rationale: Daily weighing and logging intake/output monitor diabetes insipidus. Confusion may signal hyponatremia, needing emergency care. Fluid limits are incorrect, desmopressin dosing is per nostril, and extra doses require a provider's order.
The nurse is teaching a client about storing their prescribed insulin. Which statement, if made by the client, would indicate a correct understanding of the teaching?
- A. Opened vials of insulin may be kept in the freezer.
- B. My opened vial of insulin is good for 45 days.
- C. If I travel, I can keep a vial of insulin in my car.
- D. Unopened vials of insulin should be stored in the refrigerator.
Correct Answer: D
Rationale: Unopened insulin vials should be refrigerated to maintain stability. Opened vials are good for about 28–30 days at room temperature, not 45 days. Freezing or storing in a car can degrade insulin.
The nurse caring for a diabetes mellitus client obtained a scheduled capillary blood glucose. The result indicated 40 mg/dL (2.22 mmol/L) [70-110 mg/dL, 4.0-11.0 mmol/L]. The client reports no symptoms. The initial action of the nurse should be which of the following?
- A. Document the finding in the medical record
- B. Repeat the capillary blood glucose test to validate the result
- C. Administer 15 grams of a quick-acting carbohydrate
- D. Administer 1 mg of glucagon subcutaneously
Correct Answer: B
Rationale: A glucose of 40 mg/dL is critically low, even without symptoms. Repeating the test validates the result, ensuring accuracy before treatment to avoid unnecessary intervention.
The following scenario applies to the next 1 items
The nurse in the intensive care unit (ICU) is caring for a 38-year-old client being treated for diabetic ketoacidosis (DKA).
Item 1 of 1
Nurses' Notes
0700 - Handoff report received. On assessment, the client’s breathing appears regular without any distress, and clear lung sounds are noted in all lung fields. Skin is warm to the touch and pink in tone; pulses 2+ and regular. Capillary refill is 3 seconds. Client is alert and oriented to person, place, and time. Two peripheral venous access devices (VAD) were noted in the right and left antecubital spaces. The right VAD had 0.9% saline infusing at 100 mL/hr, and the left had regular insulin infusing at 4 units/hr.
Physician Orders
• Continuous infusion of regular insulin per DKA protocol
• 0.9% saline at 100 mL/hr
• Basic metabolic panel (BMP) every 3 hours
• Obtain capillary blood glucose hourly
• Daily complete blood counts (CBC)
The nurse reviews the physician's orders and plans care. Complete the sentences below from the list of options. The nurse understands that the.....needs to be monitored due to the client's risk for..............
- A. complete blood count
- B. basic metabolic panel
- C. capillary blood glucose
- D. hyperglycemia
- E. hypokalemia
- F. hemoconcentration
Correct Answer: B, E
Rationale: In DKA, insulin shifts potassium into cells, risking hypokalemia. The basic metabolic panel monitors potassium and electrolytes, critical for safe treatment and avoiding arrhythmias.