Nokea
The nurse is educating a diabetic client regarding foot care. Which of the following statements by the client indicates a correct understanding of the nurse's instructions?
- A. I need to check my feet daily for sores, blisters, dry skin, and cuts.
- B. I need to wash my feet daily and keep them dry.
- C. If I get sores or blisters on my feet, I should not pop them.
- D. I need to apply cream to my heels and between my toes daily.
- E. I should wear tight compression socks on both feet.
Correct Answer: A, B, C
Rationale: Daily checks, washing, and keeping feet dry prevent complications. Not popping sores avoids infection. Cream between toes risks fungal growth, and tight socks impair circulation.
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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.
The nurse is reviewing newly prescribed medications for assigned clients. Which of the following prescribed medications should the nurse question?
- A. Furosemide for a client with hyperparathyroidism
- B. Methimazole for a client with hyperthyroidism
- C. Hydrocortisone for a client with diabetes insipidus
- D. Prazosin for a client with pheochromocytoma
Correct Answer: C
Rationale: Hydrocortisone is inappropriate for diabetes insipidus, which requires desmopressin to manage water reabsorption. Furosemide may be used in hyperparathyroidism, methimazole treats hyperthyroidism, and prazosin manages hypertension in pheochromocytoma.
The nurse is assessing a client with diabetic ketoacidosis (DKA). Which of the following would be an expected finding?
- A. Thready pulse
- B. Jugular venous distention (JVD)
- C. Coarse tremors
- D. Tachycardia
- E. Orthostatic hypotension
Correct Answer: A, D, E
Rationale: DKA causes dehydration, leading to thready pulse, tachycardia, and orthostatic hypotension. JVD suggests fluid overload, and coarse tremors are not typical.
The following scenario applies to the next 1 items.
The nurse is caring for a client in the emergency department (ED) with an altered level of consciousness
Item 1 of 1
History and Physical
A 53-year-old male presented to the emergency department (ED) with his wife because the client had become quite tired over the past several days. Today, he was difficult to arouse and spoke incoherently. The client responded to his name during the assessment but did not answer any other questions. Peripheral pulses were thready. Obvious tenting was noted in the skin, which was warm and quite dry. No facial drooping was observed, and when asked to hold out his arms, he could not perform the task. In fact, he did not have many purposeful movements during the exam. The client has a medical history of gout, bipolar disorder, and hypothyroidism, for which he takes levothyroxine, allopurinol, and quetiapine. She reports that he has been taking his medications as prescribed. However, she noted he was recently placed on Prednisone 20 mg PO BID for a gout flare. He self-discontinued the drug after taking it for two weeks and feeling better, and he did not taper as directed.
Vital Signs
Temperature 98.0° F (37° C)
Pulse 121/minute
Respirations 16/minute
Blood Pressure 90/60 mm Hg
Pulse oximetry 95% on room air
Diagnostics
12-lead electrocardiogram: sinus tachycardia with peaked T waves
Complete the sentence below by dragging one (1) condition and one (1) assessment finding. The client is at highest risk for............. related to the client's...........
- A. myxedema coma
- B. catatonia
- C. adrenal crisis
- D. cessation of prednisone
- E. lack of purposeful movement
- F. history of hypothyroidism
Correct Answer: C, D
Rationale: Abrupt cessation of prednisone in a client on chronic steroids can precipitate adrenal crisis due to suppressed adrenal function. Altered consciousness, thready pulses, and dehydration support this risk.
The nurse has instructed a client scheduled for an injection of dulaglutide for diabetes mellitus (type two). Which of the following statements by the client would require follow-up?
- A. I should tell my doctor if I experience abdominal pain and vomiting.
- B. I should take this medication within one hour of eating a meal.
- C. If this medication works, I should notice a reduction in my hemoglobin A1C (HbA1c).
- D. I will receive this medication once a week.
Correct Answer: B
Rationale: Dulaglutide, a GLP-1 agonist, is taken weekly regardless of meals, not within one hour of eating. Abdominal pain/vomiting should be reported, HbA1c reduction is expected, and weekly dosing is correct.