Nokea
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.
You may also like to solve these questions
The nurse is conducting health screenings for hypothyroidism at the community health fair. Which client is at the highest risk for this condition? A client who is
- A. underweight, anxious, has a rapid pulse, and reports persistent diarrhea.
- B. overweight, reports perspiration while playing sports, and reports feeling cold all the time.
- C. obese, has high blood pressure, and has frequent reports of thirst.
- D. obese, has periorbital edema, and reports a decrease in motivation.
Correct Answer: D
Rationale: Hypothyroidism causes weight gain, edema, and fatigue or decreased motivation. Underweight, rapid pulse, and diarrhea suggest hyperthyroidism; thirst and hypertension are less specific.
The nurse is reviewing the diet of the client with hypoparathyroidism. The nurse understands that the client should be on what type of diet?
- A. High-calorie, low-calcium diet
- B. Low-calcium, low-phosphorus diet
- C. High-phosphorus, low-calcium diet
- D. High-calcium, low-phosphorus diet
Correct Answer: D
Rationale: Hypoparathyroidism reduces PTH, lowering calcium. A high-calcium, low-phosphorus diet compensates, as high phosphorus can further bind calcium.
The nurse is caring for a client diagnosed with a myxedema coma. The nurse should anticipate a prescription for which of the following medications?
- A. Levothyroxine
- B. Methimazole
- C. Tolvaptan
- D. Hydrochlorothiazide
- E. Hydrocortisone
Correct Answer: A,E
Rationale: Myxedema coma, a severe hypothyroidism emergency, requires levothyroxine to restore thyroid hormone levels and hydrocortisone to address potential adrenal insufficiency. Methimazole treats hyperthyroidism, and tolvaptan and hydrochlorothiazide manage fluid balance, not hypothyroidism.
The nurse is caring for a client who has diabetic ketoacidosis (DKA). Which of the following would indicate the client is achieving the treatment goals?
- A. Mean arterial pressure (MAP) 71 mmHg
- B. Potassium 3.3 mEq/L (mmol) [3.5-5 mEq/L]
- C. Blood glucose 255 mg/dL (14.15 mmol/L) [70-110 mg/dL, 4.0-11.0 mmol/L]
- D. Serum pH 7.33 [7.35 and 7.45]
Correct Answer: D
Rationale: In DKA, treatment aims to correct acidosis, hyperglycemia, and electrolyte imbalances. A serum pH of 7.33 is closer to the normal range (7.35-7.45), indicating improvement in acidosis. MAP of 71 mmHg is low, potassium is below normal, and glucose remains elevated, suggesting ongoing issues.
The nurse plans care for a client experiencing a hyperglycemic-hyperosmolar state (HHS). The nurse should anticipate which prescriptions from the primary healthcare provider (PHCP)?
- A. 0.9% saline infusion
- B. Glargine insulin
- C. Sodium polystyrene
- D. Sodium bicarbonate
Correct Answer: A
Rationale: HHS involves severe hyperglycemia and dehydration. 0.9% saline corrects fluid loss. Glargine is long-acting and not ideal for acute HHS, sodium polystyrene treats hyperkalemia, and bicarbonate is rarely used unless pH is critically low.