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The nurse is caring for a client with diabetes who is being discharged with a prescription for glyburide. Which statement by the client indicates a need for further instruction?
- A. I should avoid alcohol intake with this new medication.
- B. I should call my primary health care provider if my morning blood glucose is below 60 mg/dL (3.3 mmol/L).
- C. I should read the labels on all foods I eat, including those that say 'sugarless'.
- D. This medication will help me lose weight.
Correct Answer: D
Rationale: Glyburide stimulates insulin release to lower blood glucose but does not promote weight loss; it may cause weight gain. Avoiding alcohol, reporting hypoglycemia, and checking food labels are correct actions, indicating understanding.
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A client with chronic kidney disease has an arteriovenous fistula placed in the left wrist for hemodialysis. Which of the following statements indicate that the client understands how to care for the fistula properly? Select all that apply.
- A. I should not worry if I have slight numbness or tingling in my left arm.
- B. I will be sure to avoid sleeping on my left arm.
- C. I will make sure that I always have my blood pressure taken in my left arm.
- D. I will squeeze a small sponge with my left hand several times a day.
- E. I will touch the site and feel for a vibration several times a day.
Correct Answer: B,D,E
Rationale: Avoiding sleeping on the arm prevents pressure on the fistula, squeezing a sponge promotes circulation, and feeling for a thrill ensures patency. Numbness/tingling requires evaluation, and blood pressure should be taken on the opposite arm to avoid fistula damage.
The nurse is contributing to the plan of care for a client with diabetes who reports breast tenderness, vaginal discharge, and urinary frequency. Which action is most important to include in the plan of care?
- A. Ask if the client performs breast self-exams
- B. Ask the client about characteristics of vaginal discharge
- C. Determine the date of the client's last menstrual period
- D. Review the client's home blood sugar logs
Correct Answer: C
Rationale: Determining the date of the client's last menstrual period is critical to assess for pregnancy or menopausal changes, which could explain the symptoms and impact diabetes management. Breast self-exams and vaginal discharge characteristics are less urgent, and blood sugar logs, while important, are not directly related to the reported symptoms.
An adolescent tells the nurse that she is afraid she will get AIDS and asks how she can avoid this. What should be included in the nurse's response? Select all that apply.
- A. Avoid using public toilets because the virus may be on the seat.
- B. Do not have sexual intercourse until you are married.
- C. Using a condom lowers the risk of contracting HIV.
- D. Oral contraceptives lower the risk of contracting HIV.
- E. Do not share razors with anyone else.
- F. The virus may be transmitted by drinking from the same glass.
Correct Answer: C,E
Rationale: Condoms reduce HIV transmission risk during sexual activity, and not sharing razors prevents bloodborne exposure. Public toilets, abstinence until marriage, oral contraceptives, and sharing glasses are not relevant to HIV prevention.
A nurse is documenting notes in the client's electronic record after making rounds on assigned clients. Which entry is an appropriate documentation?
- A. Client appears to be sleeping. Eyes closed
- B. Client reports, 'I'm in pain.' Medication provided
- C. Inspiratory wheezes heard in bilateral lower lung fields
- D. Voided x1
Correct Answer: C
Rationale: Inspiratory wheezes in bilateral lower lung fields is a specific, objective finding that accurately describes the client's condition. The other entries are vague, lack detail, or are subjective without supporting data.
The nurse has been assigned a client who is thought to be suicidal. All of the following are in the client's room. Which is safe to leave in the room?
- A. Paper cup
- B. Leather belt
- C. Razor
- D. Pillow
Correct Answer: A
Rationale: A paper cup poses no suicide risk. Belts, razors, and pillows (potential suffocation) are unsafe in a suicidal client's room.