Nokea
The nurse is teaching a client about diabetes mellitus. Which of the following information should the nurse include?
- A. You will need yearly hemoglobin A1C lab tests.
- B. Your diet should consist mostly of simple carbohydrates.
- C. Annual visual examinations are recommended.
- D. You should take more insulin before exercising.
- E. Your liver enzymes will be monitored closely.
- F. Check your blood sugar if you start to feel shaky.
Correct Answer: A, C, F
Rationale: HbA1C monitors long-term control, ideally every 3 months, but yearly is a start. Annual eye exams detect retinopathy. Checking glucose during shakiness prevents hypoglycemia. Simple carbs raise glucose rapidly, insulin needs vary, and liver monitoring is not routine.
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The nurse has received an order to prepare a client for a water deprivation test. The nurse understands that this test is used to diagnose
- A. hyperthyroidism
- B. pheochromocytoma
- C. diabetes insipidus (DI)
- D. syndrome of inappropriate antidiuretic hormone (SIADH)
Correct Answer: C
Rationale: The water deprivation test diagnoses diabetes insipidus by assessing the body's ability to concentrate urine without fluid intake, distinguishing it from SIADH or other conditions.
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 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 who has diabetic ketoacidosis (DKA). Which of the following would indicate the client is achieving the treatment goals?
- A. Mean arterial pressure (MAP) 71 mmHg
- B. Potassium 3.3 mEq/L (mmol) [3.5-5 mEq/L]
- C. Blood glucose 255 mg/dL (14.15 mmol/L) [70-110 mg/dL, 4.0-11.0 mmol/L]
- D. Serum pH 7.33 [7.35 and 7.45]
Correct Answer: D
Rationale: In DKA, treatment aims to correct acidosis, hyperglycemia, and electrolyte imbalances. A serum pH of 7.33 is closer to the normal range (7.35-7.45), indicating improvement in acidosis. MAP of 71 mmHg is low, potassium is below normal, and glucose remains elevated, suggesting ongoing issues.
The nurse is caring for assigned clients. The nurse should recognize which client is at risk of developing hypoglycemia? A client
- A. with diabetic ketoacidosis receiving continuous regular insulin intravenously.
- B. receiving methylprednisolone for an exacerbation of asthma.
- C. with pancreatitis and is receiving total parenteral nutrition (TPN).
- D. who is nothing by mouth (NPO) status following a coronary artery bypass graft (CABG).
- E. who received six units of lispro insulin one hour ago and has not eaten.
Correct Answer: A, E
Rationale: Continuous insulin in DKA and lispro without food increase hypoglycemia risk due to excess insulin action. Steroids raise glucose, and TPN and NPO status are less directly related.