Nokea
The nurse is discussing the functions of the parathyroid hormone (PTH) with a student. Which of the following statements would be correct for the nurse to make? The parathyroid hormone
- A. moves calcium from bones to the bloodstream.
- B. promotes renal tubular reabsorption of calcium.
- C. controls bodily functions such as metabolism and heart rate.
- D. promotes renal tubular reabsorption of phosphorus.
- E. causes the retention of sodium and the excretion of potassium.
Correct Answer: A, B
Rationale: PTH raises blood calcium by mobilizing it from bones and increasing renal reabsorption. Metabolism and heart rate are thyroid functions, and PTH reduces, not increases, phosphorus reabsorption.
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The nurse is caring for a client with diabetic ketoacidosis (DKA) who is receiving an infusion of regular insulin. Which of the following clinical data should be reported to the primary healthcare provider (PHCP) immediately?
- A. Glucose 297 mg/dL, 16.52 mmol/L (70-110 mg/dL, 4.0-11.0 mmol/L)
- B. Potassium 3.2 mEq/L, 3.2 mmol/L (3.5-5 mEq/L, 3.5-5.1 mmol/L)
- C. BUN 24 mg/dL, 8.568 mmol/L (10-20 mg/dL, 2.5 to 6.4 mmol/L)
- D. Hemoglobin A1C 8.9% ( < 7%, 4.8%-6.0%)
Correct Answer: B
Rationale: In DKA, insulin shifts potassium into cells, risking hypokalemia. A level of 3.2 mEq/L is critical and needs immediate reporting to prevent arrhythmias. Glucose, BUN, and HbA1C are monitored but less urgent.
The nurse is evaluating the treatment plan for a client with type II diabetes mellitus. Select the findings in the nurses' note that indicate that the client is not meeting the treatment goals
- A. The client presents for a routine follow-up after being diagnosed with diabetes mellitus type II.
- B. The most recent hemoglobin A1C was 7.6%.
- C. A weight gain of three kilograms was noted.
- D. The client reports a painless ulcer on the right anterior ankle.
- E. The client stated he stopped walking barefoot.
- F. The client requested a referral for a diabetic cooking class.
Correct Answer: B, C, D
Rationale: HbA1C of 7.6% exceeds the target (<7%), indicating poor control. Weight gain and a painless ulcer suggest complications like poor circulation or neuropathy. Stopping barefoot walking and requesting classes are positive steps.
The nurse is teaching a client about storing their prescribed insulin. Which statement, if made by the client, would indicate a correct understanding of the teaching?
- A. Opened vials of insulin may be kept in the freezer.
- B. My opened vial of insulin is good for 45 days.
- C. If I travel, I can keep a vial of insulin in my car.
- D. Unopened vials of insulin should be stored in the refrigerator.
Correct Answer: D
Rationale: Unopened insulin vials should be refrigerated to maintain stability. Opened vials are good for about 28–30 days at room temperature, not 45 days. Freezing or storing in a car can degrade insulin.
The nurse is caring for a client who has adrenal insufficiency (Addison's disease). Which of the following interventions would be a priority?
- A. Administer prescribed hydrocortisone
- B. Offer salty snacks and water
- C. Assess skin integrity
- D. Encourage frequent rest periods
Correct Answer: A
Rationale: Adrenal insufficiency causes cortisol deficiency, leading to hypotension and weakness. Administering hydrocortisone is critical to replace cortisol and stabilize the client. Salty snacks, skin checks, and rest are supportive but not the priority.
This nurse is caring for a client who is receiving prescribed sitagliptin. Which assessment findings indicate the client is experiencing a severe adverse effect?
- A. Nasal stuffiness
- B. Abdominal pain
- C. Headache
- D. Occasional dry cough
Correct Answer: B
Rationale: Abdominal pain may indicate pancreatitis, a rare but severe sitagliptin adverse effect, requiring immediate attention. Nasal stuffiness, headache, and dry cough are less severe.