Nokea
The nurse is counseling a client who has prediabetes. The nurse understands that the client is meeting the treatment goal, as evidenced by
- A. total cholesterol of 215 mg/dL (5.55 mmol/L) [ < 200 mg/dL, < 5.2 mmol/L]
- B. hemoglobin A1C of 5.4% [ < 6.4%]
- C. fasting blood glucose 128 mg/dL (7.10 mmol/L) [70-110 mg/dL, 4.0-6.0 mmol/L]
- D. random blood glucose of 210 mg/dL (11.66 mmol/L) [70-110 mg/dL, 4.0-6.0 mmol/L]
Correct Answer: B
Rationale: Prediabetes goals include HbA1C <5.7%; 5.4% indicates good control. Elevated cholesterol, fasting, and random glucose suggest ongoing issues.
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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 has obtained a prescription for desmopressin to treat diabetes insipidus (DI). The nurse understands that it is essential to monitor the clients
- A. serum sodium level.
- B. serum glucose.
- C. serum magnesium level.
- D. serum calcium level.
Correct Answer: A
Rationale: Desmopressin treats diabetes insipidus by reducing water excretion, risking hyponatremia. Monitoring serum sodium is essential. Glucose, magnesium, and calcium are not primarily affected.
The nurse is caring for a client with Cushing's disease. Which of the following complications are associated with this condition?
- A. cataracts
- B. diabetes mellitus
- C. orthostatic hypotension
- D. osteoporosis
- E. venous thromboembolism
Correct Answer: A, B, D, E
Rationale: Cushing's excess cortisol causes cataracts, diabetes from hyperglycemia, osteoporosis from bone loss, and thromboembolism from hypercoagulability. Orthostatic hypotension is not typical.
The nurse is caring for a client scheduled for an adrenalectomy after being diagnosed with pheochromocytoma. Which preoperative clinical data is essential for the nurse to monitor?
- A. intake and output
- B. blood glucose
- C. vital signs
- D. hemoglobin and hematocrit
Correct Answer: C
Rationale: Pheochromocytoma causes catecholamine surges, leading to hypertension and tachycardia. Monitoring vital signs is critical preoperatively to manage these fluctuations and ensure stability.
The following scenario applies to the next 1 items.
The nurse in the physician's office is caring for a 41-year-old female client.
Item 1 of 1
Progress Notes
1043
Subjective: Client presents for a follow-up appointment five weeks after she was prescribed sertraline for depressive symptoms. She reports no improvement and even reports worsening as she is having difficulty focusing at work. Specifically, she reports feeling like she is in a 'brain fog.' Two weeks ago, she started taking over-the-counter stool softeners because of constipation, which did not improve even after introducing more fiber in her diet. Finally, she reports that her shoes are no longer fitting because of edema in her ankles and feet.
Objective: Client is alert and oriented to person, place, and time. 2+ peripheral pulses. S1/S2 heart tones. Hypoactive bowel sounds in all quadrants. Clear lung sounds. Trace periorbital and 1+ pedal edema.
Assessment and plan: Will order laboratory testing as this client is showing strong clinical signs of primary hypothyroidism.
Vital Signs
T 97°F (36.1°C) P 58 RR 16 BP 107/65 Pulse oximetry reading 98% on room air
Orders
obtain thyroid panel
discontinue sertraline
The nurse reviews the physician's progress notes, orders, and the client's vital signs. Complete the sentence below with the appropriate answers. If the client has primary hypothyroidism, the client's thyroid panel will have a high...... and low......
- A. thyroid-stimulating hormone (TSH)
- B. free thyroxine (T4)
- C. serum triiodothyronine (T3)
- D. thyroid-stimulating hormone (TSH).
- E. free thyroxine (T4).
- F. thyrotropin receptor antibodies (TRAbs).
Correct Answer: A, B
Rationale: Primary hypothyroidism involves low thyroid hormone production, so TSH rises to stimulate the gland, and free T4 falls due to reduced output. T3 and TRAbs are less specific here.