Nokea
The nurse is preparing to administer metformin to a client with diabetes mellitus (type two). Which of the following laboratory test results should the nurse monitor during the therapy?
- A. white blood cell (WBC) count
- B. vitamin B12 level
- C. serum uric acid level
- D. thyroid-stimulating hormone (TSH) level
Correct Answer: B
Rationale: Metformin can cause vitamin B12 deficiency over time, requiring monitoring. WBC, uric acid, and TSH are not primarily affected by metformin.
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The nurse is caring for a client diagnosed with a myxedema coma. The nurse should anticipate a prescription for which of the following medications?
- A. Levothyroxine
- B. Methimazole
- C. Tolvaptan
- D. Hydrochlorothiazide
- E. Hydrocortisone
Correct Answer: A,E
Rationale: Myxedema coma, a severe hypothyroidism emergency, requires levothyroxine to restore thyroid hormone levels and hydrocortisone to address potential adrenal insufficiency. Methimazole treats hyperthyroidism, and tolvaptan and hydrochlorothiazide manage fluid balance, not hypothyroidism.
The nurse is caring for a client with diabetes mellitus (type one) with diabetic ketoacidosis (DKA). Which laboratory result is critical for the nurse to monitor closely during the client's treatment?
- A. Blood urea nitrogen (BUN)
- B. Serum creatinine
- C. Serum potassium
- D. Serum magnesium
Correct Answer: C
Rationale: In DKA, insulin shifts potassium into cells, risking hypokalemia, which can cause arrhythmias. Close monitoring of serum potassium is critical during treatment.
The nurse is caring for a client with syndrome of inappropriate antidiuretic hormone (SIADH). Which of the following laboratory tests require careful monitoring?
- A. Potassium
- B. Sodium
- C. Glucose
- D. Magnesium
Correct Answer: B
Rationale: SIADH causes water retention, diluting sodium and risking hyponatremia. Close sodium monitoring prevents neurological complications like seizures or coma.
The nurse is teaching a review course on foods appropriate to treat hypoglycemia. It indicates appropriate understanding if an attendee states that which item should be provided?
- A. Slice of chicken breast
- B. 1 tablespoon of honey
- C. 1/2 cup of regular soda
- D. 1/2 cup of juice
- E. Two hardboiled eggs
Correct Answer: B, C, D
Rationale: Hypoglycemia requires fast-acting carbs: honey, regular soda, and juice raise glucose quickly. Protein-rich chicken and eggs are slow to digest and not effective for acute treatment.
The nurse is counseling a client who has prediabetes. The nurse understands that the client is meeting the treatment goal, as evidenced by
- A. total cholesterol of 215 mg/dL (5.55 mmol/L) [ < 200 mg/dL, < 5.2 mmol/L]
- B. hemoglobin A1C of 5.4% [ < 6.4%]
- C. fasting blood glucose 128 mg/dL (7.10 mmol/L) [70-110 mg/dL, 4.0-6.0 mmol/L]
- D. random blood glucose of 210 mg/dL (11.66 mmol/L) [70-110 mg/dL, 4.0-6.0 mmol/L]
Correct Answer: B
Rationale: Prediabetes goals include HbA1C <5.7%; 5.4% indicates good control. Elevated cholesterol, fasting, and random glucose suggest ongoing issues.