Nokea
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.
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The nurse is attending to a client with recent, significant weight gain. Which of the following diseases decreases the basal metabolic rate?
- A. Cancer
- B. Hypothyroidism
- C. Chronic obstructive pulmonary disease (COPD)
- D. Cardiac failure
Correct Answer: B
Rationale: Hypothyroidism slows metabolism, reducing basal metabolic rate and causing weight gain. Cancer, COPD, and cardiac failure often increase metabolic demand or are unrelated.
The nurse is teaching a client prescribed prednisolone. Which of the following information should the nurse include?
- A. Take this medication in the morning with food.
- B. The best time to take this medication is later in the afternoon without food.
- C. This medication before bed with a light snack.
- D. You can take this medication anytime, as long as you take it on an empty stomach.
Correct Answer: A
Rationale: Prednisolone should be taken in the morning with food to align with cortisol rhythms and minimize gastrointestinal upset. Afternoon, bedtime, or empty-stomach dosing increases side effects or reduces efficacy.
A nurse is caring for a client receiving metformin. Which of the following laboratory data should be reported to the provider?
- A. Decreased blood urea nitrogen (BUN) level
- B. Decreased glomerular filtration rate (GFR)
- C. Decreased fasting plasma glucose
- D. Decreased hemoglobin A1C
Correct Answer: B
Rationale: A decreased GFR indicates renal impairment, increasing the risk of metformin-associated lactic acidosis, requiring immediate reporting. Decreased BUN, glucose, and HbA1c are expected or less urgent.
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 caring for a client who recently had a dosage increase of prescribed levothyroxine. Which of the assessments following the increase is a priority?
- A. Weight
- B. Heart rate
- C. Activity status
- D. Oral temperature
Correct Answer: B
Rationale: Levothyroxine increases metabolism, and a dosage increase can cause hyperthyroidism symptoms, including tachycardia. Monitoring heart rate is a priority to detect adverse effects like arrhythmias. Weight, activity status, and temperature are relevant but less urgent.