Nokea
The nurse is caring for a client with diabetes mellitus (type one) with diabetic ketoacidosis (DKA). Which laboratory result is critical for the nurse to monitor closely during the client's treatment?
- A. Blood urea nitrogen (BUN)
- B. Serum creatinine
- C. Serum potassium
- D. Serum magnesium
Correct Answer: C
Rationale: In DKA, insulin shifts potassium into cells, risking hypokalemia, which can cause arrhythmias. Close monitoring of serum potassium is critical during treatment.
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The nurse is caring for assigned clients. The nurse should recognize which client is at risk of developing hypoglycemia? A client
- A. with diabetic ketoacidosis receiving continuous regular insulin intravenously.
- B. receiving methylprednisolone for an exacerbation of asthma.
- C. with pancreatitis and is receiving total parenteral nutrition (TPN).
- D. who is nothing by mouth (NPO) status following a coronary artery bypass graft (CABG).
- E. who received six units of lispro insulin one hour ago and has not eaten.
Correct Answer: A, E
Rationale: Continuous insulin in DKA and lispro without food increase hypoglycemia risk due to excess insulin action. Steroids raise glucose, and TPN and NPO status are less directly related.
The following scenario applies to the next 1 items.
The nurse in the physician's office is caring for a 41-year-old female client.
Item 1 of 1
Progress Notes
1043
Subjective: Client presents for a follow-up appointment five weeks after she was prescribed sertraline for depressive symptoms. She reports no improvement and even reports worsening as she is having difficulty focusing at work. Specifically, she reports feeling like she is in a 'brain fog.' Two weeks ago, she started taking over-the-counter stool softeners because of constipation, which did not improve even after introducing more fiber in her diet. Finally, she reports that her shoes are no longer fitting because of edema in her ankles and feet.
Objective: Client is alert and oriented to person, place, and time. 2+ peripheral pulses. S1/S2 heart tones. Hypoactive bowel sounds in all quadrants. Clear lung sounds. Trace periorbital and 1+ pedal edema.
Assessment and plan: Will order laboratory testing as this client is showing strong clinical signs of primary hypothyroidism.
Vital Signs
T 97°F (36.1°C) P 58 RR 16 BP 107/65 Pulse oximetry reading 98% on room air
Orders
obtain thyroid panel
discontinue sertraline
The nurse reviews the physician's progress notes, orders, and the client's vital signs. Complete the sentence below with the appropriate answers. If the client has primary hypothyroidism, the client's thyroid panel will have a high...... and low......
- A. thyroid-stimulating hormone (TSH)
- B. free thyroxine (T4)
- C. serum triiodothyronine (T3)
- D. thyroid-stimulating hormone (TSH).
- E. free thyroxine (T4).
- F. thyrotropin receptor antibodies (TRAbs).
Correct Answer: A, B
Rationale: Primary hypothyroidism involves low thyroid hormone production, so TSH rises to stimulate the gland, and free T4 falls due to reduced output. T3 and TRAbs are less specific here.
The nurse has received an order to prepare a client for a water deprivation test. The nurse understands that this test is used to diagnose
- A. hyperthyroidism
- B. pheochromocytoma
- C. diabetes insipidus (DI)
- D. syndrome of inappropriate antidiuretic hormone (SIADH)
Correct Answer: C
Rationale: The water deprivation test diagnoses diabetes insipidus by assessing the body's ability to concentrate urine without fluid intake, distinguishing it from SIADH or other conditions.
The nurse has obtained a prescription for desmopressin to treat diabetes insipidus (DI). The nurse understands that it is essential to monitor the clients
- A. serum sodium level.
- B. serum glucose.
- C. serum magnesium level.
- D. serum calcium level.
Correct Answer: A
Rationale: Desmopressin treats diabetes insipidus by reducing water excretion, risking hyponatremia. Monitoring serum sodium is essential. Glucose, magnesium, and calcium are not primarily affected.
The nurse is assisting a client with their newly prescribed insulin pump. The nurse understands which insulin is commonly loaded into the pump?
- A. Rapid acting
- B. Ultra long-acting insulin
- C. Intermediate acting
- D. Long acting
Correct Answer: A
Rationale: Rapid-acting insulin, such as lispro or aspart, is used in insulin pumps to mimic physiological insulin delivery for basal and bolus dosing. Long-acting or intermediate-acting insulins are not suitable for pumps.