Nokea
The nurse is planning care for a client following bilateral adrenalectomy. The nurse should anticipate a prescription for which postoperative medication?
- A. Pantoprazole
- B. Propylthiouracil (PTU)
- C. Propranolol
- D. Hydrocortisone
Correct Answer: D
Rationale: Bilateral adrenalectomy removes adrenal glands, necessitating lifelong hydrocortisone replacement to provide glucocorticoids and prevent adrenal insufficiency. Pantoprazole, PTU, and propranolol are not indicated for this purpose.
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The nurse is caring for a client with the syndrome of inappropriate antidiuretic hormone (SIADH). Which assessment finding requires immediate follow-up?
- A. Disorientation
- B. High urine specific gravity
- C. Oliguria
- D. Increased thirst
Correct Answer: A
Rationale: SIADH causes water retention and hyponatremia, which can lead to disorientation—a neurological symptom requiring urgent follow-up to prevent seizures or coma. Other findings are expected.
The nurse has provided medication instruction to a client who has been prescribed metformin. Which of the following statements, if made by the client, would indicate a correct understanding of the teaching?
- A. This medication may cause me to have bloating or loose stools.
- B. I will need to take my blood glucose prior to taking this medication.
- C. If I eat fewer carbohydrates in a day, I should skip a dose.
- D. The goal of this medication is to increase my hemoglobin A1C.
Correct Answer: A
Rationale: Metformin commonly causes gastrointestinal side effects like bloating or loose stools. Blood glucose checks are not required before dosing, skipping doses is inappropriate, and metformin aims to lower, not increase, HbA1c.
The nurse is educating a group of students on the effects of corticosteroids. It would be appropriate for the nurse to identify the following adverse effects associated with corticosteroids.
- A. Mood lability
- B. Immunosuppression
- C. Hypoglycemia
- D. Hyperkalemia
- E. Weight gain
Correct Answer: A, B, E
Rationale: Corticosteroids cause mood changes, suppress immunity, and promote weight gain via fluid retention and fat redistribution. They cause hyperglycemia, not hypoglycemia, and hypokalemia, not hyperkalemia.
The following scenario applies to the next 1 items
The nurse in physician's office is caring for a 41-year-old male
Item 1 of 1
Nurses' Notes
1100 - Client presents for a routine follow-up and a medication refill. Client has no acute concerns and reports full adherence to his prescribed medications. Vital signs: T 97.5° F (36.4° C), P 90, RR 18, BP 138/88, pulse oximetry reading 96% on room air.
Medical History
• diabetes mellitus (type 2)
• hyperlipidemia
• hypertension
• irritable bowel syndrome
Current Medications
• metformin 1 gram by mouth daily
• glipizide 5 mg by mouth daily, before breakfast
• lisinopril 40 mg by mouth daily
• multivitamin 1 tablet by mouth daily
• atorvastatin 80 mg by mouth daily
The nurse reviews the client's medical record. Please complete the sentence below from the list of options. Based on the August glycated hemoglobin A1C results the client is
- A. going to require a prescription for insulin.
- B. having frequent episodes of hyperglycemia.
- C. demonstrating evidence of good glucose control.
- D. None of the above
Correct Answer: C
Rationale: Without specific HbA1C results, stable type 2 diabetes with adherence to metformin and glipizide suggests good control, assuming prior results were within target (<7%).
The nurse is assessing a client with diabetes mellitus type 2. Which of the following findings would be consistent with a diagnosis of diabetes mellitus type 2?
- A. Fasting blood glucose level 110 mg/dL (6.1 mmol/L) [70-110 mg/dL, 4.0-6.0 mmol/L]
- B. Hemoglobin A1c (HbA1c) level 7.5% [ < 5.7%]
- C. Elevated Serum Insulin Levels
- D. Presence of ketones in the urine
Correct Answer: B
Rationale: HbA1c of 7.5% indicates poor long-term glucose control, consistent with type 2 diabetes (diagnosis: ≥6.5%). Fasting glucose at 110 mg/dL is borderline, elevated insulin reflects resistance, and ketones are more typical of type 1 or DKA.