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The nurse is caring for a client with syndrome of inappropriate antidiuretic hormone (SIADH). Which of the following laboratory tests require careful monitoring?
- A. Potassium
- B. Sodium
- C. Glucose
- D. Magnesium
Correct Answer: B
Rationale: SIADH causes water retention, diluting sodium and risking hyponatremia. Close sodium monitoring prevents neurological complications like seizures or coma.
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The nurse is caring for a client who has diabetes mellitus. Which of the following would indicate the client is achieving the treatment goals?
- A. Fasting blood glucose 145 mg/dl (8.05 mmol/L) [70-110 mg/dL, 4.0-6.0 mmol/L]
- B. Creatinine 2.3 mg/dl (203.32 μmol/L) [Male: 0.6-1.2 mg/dL Female: 0.5-1.1 mg/dL, Male 49-93 ¼mol/L Female 22-75 ¼mol/L]
- C. Urine Specific Gravity 1.043 [1.005-1.030]
- D. Hemoglobin A1C 6.7% [ < 7%]
Correct Answer: D
Rationale: HbA1C of 6.7% indicates good long-term glucose control (target <7%). Elevated fasting glucose, creatinine, and urine specific gravity suggest poor control or complications like renal issues.
The nurse is educating a client about newly prescribed lispro insulin. The nurse should instruct the client to self-administer this insulin
- A. 30-45 minutes before a meal.
- B. one hour after a meal.
- C. 20-30 minutes before a meal.
- D. 5-15 minutes before a meal.
Correct Answer: D
Rationale: Lispro, a rapid-acting insulin, should be administered 5–15 minutes before meals to match carbohydrate intake and prevent postprandial hyperglycemia. Other timings are incorrect for its rapid onset.
The nurse is caring for a client who presents with a blood glucose level of 45 mg/dL (2.4975 mmol/L) [70-110 mg/dL, 4.0-11.0 mmol/L]. Which of the following findings are expected?
- A. Blurred vision
- B. Increased urinary output
- C. Cool and clammy skin
- D. Palpitations
- E. Orthostatic hypotension
- F. Paresthesias
Correct Answer: C, D, F
Rationale: Hypoglycemia causes sympathetic activation (cool, clammy skin; palpitations) and neurological symptoms (paresthesias). Blurred vision and increased urination are more typical of hyperglycemia, and orthostatic hypotension is less directly related.
The nurse is performing discharge teaching for a client with Graves' disease. Which of the following client statements indicates effective understanding?
- A. I will take my pulse daily and report a rate less than 60 beats/minute.
- B. I am going to add hot yoga to my exercise routine.
- C. I will increase the amount of fiber in my diet.
- D. I should tell my physician if my blood pressure's top number exceeds 140.
Correct Answer: D
Rationale: Graves' causes hypertension; reporting systolic BP >140 allows timely intervention. Bradycardia is not typical, hot yoga may worsen heat intolerance, and fiber is unrelated to Graves' management.
The nurse is teaching a client about diabetes mellitus. Which of the following information should the nurse include?
- A. You will need yearly hemoglobin A1C lab tests.
- B. Your diet should consist mostly of simple carbohydrates.
- C. Annual visual examinations are recommended.
- D. You should take more insulin before exercising.
- E. Your liver enzymes will be monitored closely.
- F. Check your blood sugar if you start to feel shaky.
Correct Answer: A, C, F
Rationale: HbA1C monitors long-term control, ideally every 3 months, but yearly is a start. Annual eye exams detect retinopathy. Checking glucose during shakiness prevents hypoglycemia. Simple carbs raise glucose rapidly, insulin needs vary, and liver monitoring is not routine.