Nokea
The nurse is evaluating a diabetic client's understanding of the signs of hyperglycemia. Which statement by the client reflects an understanding?
- A. I may become diaphoretic and faint.
- B. I may notice signs of fatigue, dry skin, and increased urination.
- C. I need to take an extra diabetic pill if my blood glucose is greater than 300.
- D. I should restrict my fluid intake if my blood glucose is greater than 250.
Correct Answer: B
Rationale: Fatigue, dry skin, polyuria, and polydipsia are classic symptoms of hyperglycemia. Fatigue occurs because of lack of energy from the inability of the body to use glucose. Dry skin occurs secondary to dehydration related to polyuria. Polydipsia occurs secondary to fluid loss. Diaphoresis is associated with hypoglycemia. A client should not take extra hypoglycemic agents to reduce an elevated blood glucose level. A client with hyperglycemia becomes dehydrated secondary to the osmotic effect of the elevated glucose; therefore, the client must increase fluid intake.
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A client with a history of type 1 diabetes is admitted with hypoglycemia. The nurse should administer which of the following if the client is conscious?
- A. Glucagon intramuscularly.
- B. 50% dextrose intravenously.
- C. Orange juice orally.
- D. Insulin subcutaneously.
Correct Answer: C
Rationale: Orange juice provides fast-acting carbohydrates to raise blood glucose in a conscious client with hypoglycemia.
A neonate is to receive an I.V. infusion of normal saline solution at 3 mL/hour. The nurse is setting the alarms on an I.V. infusion pump. How should the nurse set the alarms?
- A. At 5% above and below the keep-vein-open rate.
- B. Within a 15% range of the keep-vein-open rate.
- C. To sound when the infusion is infiltrating.
- D. At the exact drip rate as prescribed.
Correct Answer: D
Rationale: For precise low-rate infusions like 3 mL/hour, the alarm should be set at the exact rate to ensure accuracy and detect deviations promptly. Infiltration alarms are not standard on most pumps.
A client with a history of liver cirrhosis is admitted with ascites. The nurse should monitor the client for which of the following complications?
- A. Hypotension.
- B. Respiratory distress.
- C. Hyperkalemia.
- D. Hypoglycemia.
Correct Answer: B
Rationale: Ascites can compress the diaphragm, leading to respiratory distress, a complication the nurse should monitor for in cirrhosis.
A client with type 1 diabetes mellitus asks the nurse whether he can take ginseng at home. The nurse should tell the client:
- A. No, there are no therapeutic benefits of ginseng
- B. You can take the ginseng to help improve your memory
- C. You can take ginseng if you take it with a carbohydrate
- D. You should ask your physician, as ginseng may affect blood sugar levels
Correct Answer: D
Rationale: Ginseng may affect blood sugar levels, potentially interacting with diabetes management, so the client should consult their physician. Ginseng has potential benefits but requires caution in diabetes.
A 13-year-old male was kidnapped and held for ransom by two criminals. His parents asked to have him admitted to the adolescent psychiatric unit. He is sleep-deprived, filthy, alternating between sobbing and making threats to kill his captors, and then asks to go to sleep. What is the best initial plan for this client?
- A. Encourage him to talk with the Federal Bureau of Investigation (FBI) about the crime details.
- B. Develop trust and allow him to talk about his memories and feelings.
- C. Help him and his parents prepare for the future trial.
- D. Discourage him from making threats toward his captors.
Correct Answer: B
Rationale: Building trust and allowing the client to express feelings addresses immediate emotional needs and trauma, prioritizing mental health support.