The nurse is discussing ways to prevent diabetic ketoacidosis with the client diagnosed with type 1 diabetes. Which instruction is most important to discuss with the client?
- A. Refer the client to the American Diabetes Association.
- B. Do not take any over-the-counter (OTC) medications.
- C. Take the prescribed insulin even when unable to eat because of illness.
- D. Explain the need to get the annual flu and pneumonia vaccines.
Correct Answer: C
Rationale: Continuing insulin during illness prevents DKA by maintaining glucose control. ADA referral, avoiding OTC meds, and vaccines are secondary.
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The client diagnosed with acute pancreatitis is being discharged home. Which statement by the client indicates the teaching has been effective?
- A. I should decrease my intake of coffee, tea, and cola.
- B. I will eat a low-fat diet and avoid spicy foods.
- C. I will check my amylase and lipase levels daily.
- D. I will return to work tomorrow but take it easy.
Correct Answer: B
Rationale: A low-fat, non-spicy diet prevents pancreatitis exacerbation, indicating effective teaching. Caffeine reduction is secondary, amylase/lipase are not self-monitored, and early work return is risky.
Which client problem has priority for the client diagnosed with acute pancreatitis?
- A. Risk for fluid volume deficit.
- B. Alteration in comfort.
- C. Imbalanced nutrition: less than body requirements.
- D. Knowledge deficit.
Correct Answer: A
Rationale: Fluid volume deficit is the priority in acute pancreatitis due to vomiting and third-spacing, risking hypovolemia. Pain, nutrition, and knowledge are secondary.
The client diagnosed with a pituitary tumor developed syndrome of inappropriate antidiuretic hormone (SIADH). Which interventions should the nurse implement?
- A. Assess for dehydration and monitor blood glucose levels.
- B. Assess for nausea and vomiting and weigh daily.
- C. Monitor potassium levels and encourage fluid intake.
- D. Administer vasopressin IV and conduct a fluid deprivation test.
Correct Answer: B
Rationale: Nausea/vomiting and daily weights monitor SIADH complications (e.g., hyponatremia, fluid overload). Dehydration is unlikely, potassium is less critical, and vasopressin worsens SIADH.
The client admitted to rule out pancreatic islet tumors complains of feeling weak, shaky, and sweaty. Which priority intervention should be implemented by the nurse?
- A. Start an IV with D5W.
- B. Notify the health-care provider.
- C. Perform a bedside glucose check.
- D. Give the client some orange juice.
Correct Answer: C
Rationale: Weakness, shakiness, and sweating suggest hypoglycemia from an insulinoma; a glucose check confirms this, guiding treatment. IV D5W, HCP notification, and juice follow confirmation.
The nurse is providing teaching to multiple clients. Which client should the nurse determine would benefit if the following illustration were utilized when teaching?
- A. The client with hyperthyroidism
- B. The client with diabetes mellitus
- C. The client with Addison's disease
- D. The client with Cushing's syndrome
Correct Answer: D
Rationale: Clinical manifestations of Cushing's syndrome, such as moon face and fat pads, match the illustration.
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