The nurse is discussing the importance of exercising with a client diagnosed with type 2 diabetes whose diabetes is well controlled with diet and exercise. Which information should the nurse include in the teaching about diabetes?
- A. Eat a simple carbohydrate snack before exercising.
- B. Carry peanut butter crackers when exercising.
- C. Encourage the client to walk 20 minutes three (3) times a week.
- D. Perform warm-up and cool-down exercises.
Correct Answer: D
Rationale: Warm-up and cool-down exercises prevent injury during exercise, crucial for type 2 diabetics. Pre-exercise snacks are for insulin users, peanut butter is high-fat, and walking is good but not the focus.
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The emergency department nurse is caring for a client diagnosed with HHNS who has a blood glucose of 680 mg/dL. Which question should the nurse ask the client to determine the cause of this acute complication?
- A. When is the last time you took your insulin?
- B. When did you have your last meal?
- C. Have you had some type of infection lately?
- D. How long have you had diabetes?
Correct Answer: C
Rationale: Infections are a common trigger for HHNS, precipitating hyperglycemia. Insulin timing, meal timing, and diabetes duration are less directly causative.
A woman with hypothyroidism asks the nurse why the doctor told her she cannot have a sedative. The nurse's response is based on which of the following facts?
- A. Sedatives potentiate thyroid replacement medication.
- B. Clients with hypothyroidism have increased susceptibility to all sedative drugs.
- C. Sedatives will have a paradoxical effect on clients with hypothyroidism.
- D. Sedatives would cause fluid retention and hypernatremia.
Correct Answer: B
Rationale: Hypothyroidism increases sensitivity to sedatives, risking excessive sedation or respiratory depression.
Because the client is receiving levothyroxine (Synthroid) for the first time, the nurse recognizes the need to cheese the client to assess the effect of the effect of replacement therapy. For which signs and symptoms should the nurse assess? Select all that apply.
- A. Dyspnea
- B. Palpitations
- C. Excessive bruising
- D. Raised, red rash
- E. Hyperactivity
- F. Insomnia
Correct Answer: B,E,F
Rationale: Levothyroxine can cause signs of hyperthyroidism if overdosed, including palpitations, hyperactivity, and insomnia.
The client with chronic alcoholism has chronic pancreatitis and hypomagnesemia. Which data should the nurse assess when administering magnesium sulfate to the client?
- A. Deep tendon reflexes.
- B. Arterial blood gases.
- C. Skin turgor.
- D. Capillary refill time.
Correct Answer: A
Rationale: Magnesium sulfate administration risks toxicity, especially in hypomagnesemia. Depressed deep tendon reflexes are an early sign of magnesium toxicity, requiring close monitoring. Arterial blood gases, skin turgor, and capillary refill are unrelated to magnesium therapy.
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.
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