Nokea
The nurse is caring for the client with Addisonian crisis. Which clinical change should indicate to the nurse that the therapy is effective?
- A. Increase of 25 mm Hg in the client's blood pressure
- B. Decrease of 25 mm Hg in the systolic blood pressure
- C. Increase in serum potassium from 3.4 to 5.8 mEq/dL
- D. Decrease in serum sodium from 146 to 136 mEq/L
Correct Answer: A
Rationale: An increase in BP indicates effective therapy by correcting hypotension from sodium and water depletion.
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Which documentation finding provides the best indication that the client has successfully avoided an adrenal (addisonian) crisis after surgery?
- A. The client's pedal edema has lessened.
- B. Capillary blood glucose level is within normal limits.
- C. Vital signs are within preoperative ranges.
Correct Answer: C
Rationale: Stable vital signs indicate the absence of adrenal crisis, characterized by hypotension and shock.
The nurse administers 15 units of glargine insulin at 2100 hours to the client when the client's fingerstick blood glucose reading is 110 mg/dL. At 2300, an NA reports that an evening snack was not given because the client was sleeping. Which instruction by the nurse is most appropriate?
- A. You will need to wake the client to check the blood glucose and then give a snack. All diabetics get a snack at bedtime.'
- B. It is not necessary for this client to have a snack; glargine insulin is absorbed over 24 hours and doesn't have a peak.'
- C. The next time the client wakes up, check a blood glucose level and then give a 15-gram carbohydrate snack.'
- D. I will notify the HCP; a snack at this time will affect the next blood glucose level and dose of glargine insulin.'
Correct Answer: B
Rationale: The onset of glargine is 1 hour; it has no peak action, and it lasts for 24 hours. Because it has no peak action, a bedtime snack is unnecessary.
When the client asks why a diabetic relative cannot take insulin orally, what is the best answer?
- A. Insulin is inactivated by digestive enzymes.
- B. Insulin is absorbed too quickly in the stomach.
- C. Insulin is irritating to the gastric mucosa.
- D. Insulin is incompatible with many foods.
Correct Answer: A
Rationale: Insulin is a protein that is broken down by digestive enzymes, rendering it ineffective if taken orally.
The nurse is discussing complications of chronic pancreatitis with a client diagnosed with the disease. Which complication should the nurse discuss with the client?
- A. Diabetes insipidus (DI).
- B. Crohn's disease.
- C. Narcotic addiction.
- D. Peritonitis.
Correct Answer: C
Rationale: Chronic pancreatitis often requires long-term pain management, risking narcotic addiction. DI, Crohn’s, and peritonitis are unrelated complications.
Which statement by the client about foot care indicates a need for further teaching?
- A. I need to inspect my feet daily.
- B. I should soak my feet each day.
- C. I need to wear shoes whenever I'm not sleeping.
- D. I need to schedule regular appointments with the podiatrist.
Correct Answer: B
Rationale: Soaking feet can lead to skin breakdown in diabetic clients; feet should be washed and dried carefully.