Nokea
The nurse is caring for multiple clients with DM. It is most important for the nurse to initiate a referral to a diabetes educator for which client?
- A. The client who states diabetes is well controlled with diet and exercise; Hgb A1c is 11%.
- B. The client requesting diabetes information; fingerstick glucose is 132 mg/dL, Hgb A1c is 5.6%.
- C. The client who states perfect compliance with diet, exercise, and meds; Hgb A1c is 7%.
- D. The client with short-term memory loss; fingerstick glucose is 110 mg/dL, Hgb A1c is 4.5%.
Correct Answer: A
Rationale: It is most important for the nurse to initiate a referral for clients who falsely think their diabetes is well controlled. The client's Hgb A1c, which measures average blood glucose over the previous 3 months, is 11%, indicating that the diabetes is not well controlled.
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Which response by the nurse about potassium iodide (Lugol's solution) is correct?
- A. It firms the gland so it is easily removed.
- B. It decreases the postoperative recovery time.
- C. It decreases the risk of postoperative bleeding.
- D. It eliminates the need for hormone replacement.
Correct Answer: C
Rationale: Potassium iodide reduces thyroid vascularity, decreasing the risk of postoperative bleeding.
The unlicensed assistive personnel (UAP) complains to the nurse she has filled the water pitcher four (4) times during the shift for a client diagnosed with a closed head injury and the client has asked for the pitcher to be filled again. Which intervention should the nurse implement first?
- A. Tell the UAP to fill the pitcher with ice cold water.
- B. Instruct the UAP to start measuring the client's I&O.
- C. Assess the client for polyuria and polydipsia.
- D. Check the client's BUN and creatinine levels.
Correct Answer: C
Rationale: Frequent water pitcher refills suggest polydipsia and polyuria, symptoms of diabetes insipidus post-head injury, requiring assessment. I&O, labs, and refilling follow.
The client is ready for discharge following an adrenalectomy. Which statement that the client makes indicates the best understanding of the client's condition?
- A. I will continue on a low-sodium, low-potassium diet.'
- B. My husband has arranged for a marriage counselor because of our fights.'
- C. I will stay out of the sun so I will not turn splotchy brown.'
- D. I will take all of those pills every day.'
Correct Answer: D
Rationale: Lifelong steroid replacement is required post-adrenalectomy, and taking prescribed pills daily shows understanding. A high-sodium, low-potassium diet is needed, and photosensitivity is not an issue.
The nurse is developing a plan of care for the client diagnosed with acquired immunodeficiency syndrome (AIDS) who has developed an infection in the adrenal gland. Which client problem is highest priority?
- A. Altered body image.
- B. Activity intolerance.
- C. Impaired coping.
- D. Fluid volume deficit.
Correct Answer: D
Rationale: Adrenal infection may impair aldosterone production, causing fluid volume deficit (hypovolemia), a priority. Body image, activity, and coping are psychosocial and secondary.
The female client is to be treated with radioactive iodine (RAI) therapy for an enlarged thyroid gland. The client asks if there are any precautions that are needed during RAI therapy. Which is the nurse's best response?
- A. No precautions are necessary. The radiation in the form of an oral capsule will target and destroy thyroid tissue only.'
- B. Use contraceptives or abstain from sexual intercourse to avoid conceiving during and for 6 months after treatment.'
- C. Discontinue taking the antithyroid medication and propranolol; results are seen immediately with RAI therapy.'
- D. Some people need a thyroid hormone replacement, but it is not necessary when the thyroid gland is enlarged.'
Correct Answer: B
Rationale: Pregnancy should be postponed for at least 6 months after RAI treatment because it crosses the placenta.