Nokea
The nurse is teaching a client who is receiving newly oral prednisone. Which of the following Information should the nurse include concerning the possible side effects of this medication?
- A. Increased susceptibility to infection
- B. Weight gain
- C. Insomnia
- D. Blood glucose elevation
- E. Increased urine output
Correct Answer: A,B,C,D
Rationale: Prednisone, a corticosteroid, suppresses immunity (increasing infection risk), causes weight gain, insomnia, and elevates blood glucose. Increased urine output is not a common side effect; it’s more associated with diuretics.
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The nurse is caring for a client with diabetic ketoacidosis (DKA) who is receiving an infusion of regular insulin. Which of the following clinical data should be reported to the primary healthcare provider (PHCP) immediately?
- A. Glucose 297 mg/dL, 16.52 mmol/L (70-110 mg/dL, 4.0-11.0 mmol/L)
- B. Potassium 3.2 mEq/L, 3.2 mmol/L (3.5-5 mEq/L, 3.5-5.1 mmol/L)
- C. BUN 24 mg/dL, 8.568 mmol/L (10-20 mg/dL, 2.5 to 6.4 mmol/L)
- D. Hemoglobin A1C 8.9% ( < 7%, 4.8%-6.0%)
Correct Answer: B
Rationale: In DKA, insulin shifts potassium into cells, risking hypokalemia. A level of 3.2 mEq/L is critical and needs immediate reporting to prevent arrhythmias. Glucose, BUN, and HbA1C are monitored but less urgent.
The nurse is caring for a client who has nephrogenic diabetes insipidus. Which of the following medications should the nurse expect to be prescribed for the client?
- A. prednisone
- B. hydrochlorothiazide
- C. verapamil
- D. lithium
Correct Answer: B
Rationale: Nephrogenic diabetes insipidus reduces kidney response to ADH. Hydrochlorothiazide paradoxically reduces urine output by increasing sodium excretion, concentrating urine. Prednisone, verapamil, and lithium are unrelated or worsen DI.
The following scenario applies to the next 1 items
The nurse in the intensive care unit (ICU) is caring for a 38-year-old client being treated for diabetic ketoacidosis (DKA).
Item 1 of 1
Nurses' Notes
0700 - Handoff report received. On assessment, the client’s breathing appears regular without any distress, and clear lung sounds are noted in all lung fields. Skin is warm to the touch and pink in tone; pulses 2+ and regular. Capillary refill is 3 seconds. Client is alert and oriented to person, place, and time. Two peripheral venous access devices (VAD) were noted in the right and left antecubital spaces. The right VAD had 0.9% saline infusing at 100 mL/hr, and the left had regular insulin infusing at 4 units/hr.
Physician Orders
• Continuous infusion of regular insulin per DKA protocol
• 0.9% saline at 100 mL/hr
• Basic metabolic panel (BMP) every 3 hours
• Obtain capillary blood glucose hourly
• Daily complete blood counts (CBC)
The nurse reviews the physician's orders and plans care. Complete the sentences below from the list of options. The nurse understands that the.....needs to be monitored due to the client's risk for..............
- A. complete blood count
- B. basic metabolic panel
- C. capillary blood glucose
- D. hyperglycemia
- E. hypokalemia
- F. hemoconcentration
Correct Answer: B, E
Rationale: In DKA, insulin shifts potassium into cells, risking hypokalemia. The basic metabolic panel monitors potassium and electrolytes, critical for safe treatment and avoiding arrhythmias.
The nurse is assessing a client with diabetic ketoacidosis (DKA). Which of the following would be an expected finding?
- A. Thready pulse
- B. Jugular venous distention (JVD)
- C. Coarse tremors
- D. Tachycardia
- E. Orthostatic hypotension
Correct Answer: A, D, E
Rationale: DKA causes dehydration, leading to thready pulse, tachycardia, and orthostatic hypotension. JVD suggests fluid overload, and coarse tremors are not typical.
The nurse is performing a physical assessment on a client with Cushing's disease. Which assessment findings should the nurse expect?
- A. Hypotension
- B. Acne
- C. Hirsutism
- D. Buffalo hump
- E. Truncal obesity
Correct Answer: B, C, D, E
Rationale: Cushing's disease from excess cortisol causes acne, hirsutism (excess hair), buffalo hump, and truncal obesity due to fat redistribution. Hypertension, not hypotension, is typical.