Nokea
The nurse is planning the care of a client diagnosed with Addison's disease. Which intervention should be included?
- A. Administer steroid medications.
- B. Place the client on fluid restriction.
- C. Provide frequent stimulation.
- D. Consult physical therapy for gait training.
Correct Answer: A
Rationale: Steroid replacement (e.g., hydrocortisone) is essential for Addison’s to replace deficient cortisol/aldosterone. Fluid restriction, stimulation, and gait training are inappropriate.
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Which documentation finding provides the best indication that the client has successfully avoided an adrenal (addisonian) crisis after surgery?
- A. The client's pedal edema has lessened.
- B. Capillary blood glucose level is within normal limits.
- C. Vital signs are within preoperative ranges.
Correct Answer: C
Rationale: Stable vital signs indicate the absence of adrenal crisis, characterized by hypotension and shock.
When the client asks why a diabetic relative cannot take insulin orally, what is the best answer?
- A. Insulin is inactivated by digestive enzymes.
- B. Insulin is absorbed too quickly in the stomach.
- C. Insulin is irritating to the gastric mucosa.
- D. Insulin is incompatible with many foods.
Correct Answer: A
Rationale: Insulin is a protein that is broken down by digestive enzymes, rendering it ineffective if taken orally.
The nurse is teaching the client diagnosed with type 2 diabetes mellitus about diet. Which diet selection indicates the client understands the teaching?
- A. A submarine sandwich, potato chips, and diet cola.
- B. Four (4) slices of a supreme thin-crust pizza and milk.
- C. Smoked turkey sandwich, celery sticks, and unsweetened tea.
- D. A roast beef sandwich, fried onion rings, and a cola.
Correct Answer: C
Rationale: A turkey sandwich, celery, and unsweetened tea are low-carb, low-fat, and diabetes-friendly. Other options are high in carbs or fats, worsening glycemic control.
When given the news, the client denies the diagnosis and becomes angry, stating there has been a mistake in the tests. Which nursing action is most appropriate at this time?
- A. Emphasizing the importance of treatment
- B. Reassuring the client that the disease is easily managed
- C. Explaining that many people live with diabetes
- D. Listening as the client expresses current feelings
Correct Answer: D
Rationale: Listening to the client's feelings supports emotional processing and acceptance of the diagnosis.
A client is admitted to the hospital with recently diagnosed Type I diabetes mellitus and is to have fasting blood work drawn this morning. At 7:00 A.M., the lab has not arrived to draw the blood. The client's dose of regular insulin is scheduled for 7:30 A.M. What is the best action for the nurse to take?
- A. Give the insulin as ordered
- B. Withhold the insulin until the lab comes and the client will be eating within 15 to 30 minutes
- C. Withhold the insulin until the blood has been drawn and the client has eaten
- D. Do not administer insulin until the blood work has been drawn and the results have been called back to the unit
Correct Answer: C
Rationale: Withholding insulin until blood is drawn and the client has eaten prevents hypoglycemia during fasting blood work.