Nokea
The nurse is reviewing information for the client with type 1 DM. The nurse concludes that the client may be experiencing the Somogyi phenomenon, as evidenced by which finding?
- A. 02:00 blood glucose between 80-110 mg/dL and morning levels between 80-100 mg/dL
- B. 02:00 blood glucose between 50-60 mg/dL and morning levels between 48-62 mg/dL
- C. 02:00 blood glucose between 130-140 mg/dL and morning levels between 180-200 mg/dL
- D. 02:00 blood glucose between 45-62 mg/dL and morning levels between 200-305 mg/dL
Correct Answer: D
Rationale: The nurse should conclude that the low blood glucose in the middle of the night (45-62 mg/dL) and a rebound morning hyperglycemia (200-305 mg/dL) are signs of Somogyi phenomenon, also known as Somogyi effect.
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Twelve hours after a transsphenoidal hypophysectomy, the client keeps clearing his throat and complains of a drip in his mouth. To accurately assess this, the nurse should test the fluid for:
- A. sugar.
- B. protein.
- C. bacteria.
- D. blood.
Correct Answer: A
Rationale: A post-nasal drip post-transsphenoidal hypophysectomy may indicate cerebrospinal fluid (CSF) leakage, which contains glucose (sugar), unlike saliva or mucus.
When directing the nursing assistant to weigh the client, which instruction is most important for obtaining accurate data?
- A. Have the client stand on a bedside scale.
- B. Weigh the client at the same time each day.
- C. Ask that slippers be removed when being weighed.
- D. Ask about the client's pre-disease weight.
Correct Answer: B
Rationale: Weighing the client at the same time each day ensures consistency and accounts for daily fluctuations in weight due to meals, hydration, or other factors.
The nurse teaches the client with newly diagnosed diabetes mellitus about the signs and symptoms of hypoglycemia. Which of the following should the nurse stress in teaching? Select all that apply.
- A. Sleepiness
- B. Shallow
- C. Thirst
- D. Hunger
- E. Diaphoresis
- F. Confusion
Correct Answer: D,E,F
Rationale: Hypoglycemia causes hunger, diaphoresis, and confusion due to low blood glucose affecting the brain and body.
The nurse is discharging a client diagnosed with diabetes insipidus. Which statement made by the client warrants further intervention?
- A. I will keep a list of my medications in my wallet and wear a Medic Alert bracelet.
- B. I should take my medication in the morning and leave it refrigerated at home.
- C. I should weigh myself every morning and record any weight gain.
- D. If I develop a tightness in my chest, I will call my health-care provider.
Correct Answer: B
Rationale: Desmopressin (DI medication) requires consistent dosing, not morning-only, and storage instructions are vague; this needs clarification. Other statements are appropriate.
The nurse manager of a medical-surgical unit is asked to determine if the unit should adopt a new care delivery system. Which behavior is an example of an autocratic style of leadership?
- A. Call a meeting and educate the staff on the new delivery system being used.
- B. Organize a committee to investigate the various types of delivery systems.
- C. Wait until another unit has implemented the new system and see if it works out.
- D. Discuss with the nursing staff if a new delivery system should be adopted.
Correct Answer: A
Rationale: An autocratic leader unilaterally decides and informs staff, as in educating them on a chosen system. Committees, waiting, and staff discussions are democratic or laissez-faire.