Nokea
The nurse is interviewing four clients. Which client is at the greatest risk for developing type 2 DM?
- A. 56-year-old Hispanic female
- B. 40-year-old Asian American female
- C. 25-year-old obese Caucasian male
- D. 38-year-old Native American male
Correct Answer: D
Rationale: Research has shown that the highest incidence of DM is among Native Americans.
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Which information is most important for the nurse to elicit from the client to effectively evaluate compliance with the prescribed therapy?
- A. The dosage and frequency of insulin administration
- B. The client's glucose monitoring records for the past week
- C. The client's weight and vital signs before the office interview
- D. The symptoms experienced in the past month
Correct Answer: B
Rationale: Glucose monitoring records provide direct evidence of blood glucose control and therapy compliance.
The nurse is teaching the client diagnosed with diabetes. Which should the nurse teach to limit the complications of diabetes?
- A. Teach the client to keep the blood glucose under 140 mg/dL.
- B. Demonstrate how to test the urine for ketones.
- C. Instruct the client to apply petroleum jelly between the toes.
- D. Allow the client to eat meals as desired and then take insulin.
Correct Answer: A
Rationale: Maintaining blood glucose <140 mg/dL prevents complications like neuropathy and retinopathy. Ketone testing is for type 1, petroleum jelly is incorrect, and meal-based insulin is unsafe.
Which signs/symptoms should the nurse expect to assess in the 31-year-old client who has a sustained release of growth hormone (GH)?
- A. An enlarged forehead, maxilla, and face.
- B. A six (6)-inch increase in height of the client.
- C. The client complaining of a severe headache.
- D. A systolic blood pressure of 200 to 300 mm Hg.
Correct Answer: A
Rationale: Excess GH (acromegaly) causes facial and bone enlargement (e.g., forehead, maxilla). Height increase occurs pre-puberty, headaches are nonspecific, and extreme hypertension is unrelated.
The client diagnosed with Addison's disease is admitted to the emergency department after a day at the lake. The client is lethargic, forgetful, and weak. Which intervention should the nurse implement?
- A. Start an IV with an 18-gauge needle and infuse NS rapidly.
- B. Have the client wait in the waiting room until a bed is available.
- C. Obtain a permit for the client to receive a blood transfusion.
- D. Collect urinalysis and blood samples for a CBC and calcium level.
Correct Answer: A
Rationale: Lethargy, confusion, and weakness suggest Addisonian crisis; rapid NS infusion corrects hypotension and dehydration. Waiting, transfusions, and labs are inappropriate first steps.
The nurse is discussing discharge plans with a client who had a transsphenoidal hypophysectomy. Which statement made by the client indicates a need for more teaching?
- A. I won't brush my teeth until the doctor removes the stitches.'
- B. I will wear loafers instead of tie shoes.'
- C. Where can I get a Medic-Alert bracelet?'
- D. I will take all these new medicines until I feel better.'
Correct Answer: D
Rationale: Stopping medications when feeling better indicates a lack of understanding, as lifelong hormone replacement is often required post-hypophysectomy.