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The nurse is teaching a community class to people with type 2 diabetes mellitus. Which explanation explains the development of type 2 diabetes?
- A. The islet cells in the pancreas stop producing insulin.
- B. The client eats too many foods high in sugar.
- C. The pituitary gland does not produce vasopressin.
- D. The cells become resistant to the circulating insulin.
Correct Answer: D
Rationale: Type 2 diabetes develops due to insulin resistance, where cells fail to respond to insulin. Islet cell failure is type 1, sugar intake is a risk, and vasopressin is unrelated.
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The nurse's next door neighbor calls. He says he cannot awaken his 21-year-old wife. The nurse notes that the client is unconscious and is having deep respirations. Her breath has a fruity smell to it. The husband says that his wife has been eating and drinking a lot recently and that last night she vomited before lying down. What is the most appropriate action for the nurse to take?
- A. Start cardiopulmonary resuscitation
- B. Get her to a hospital immediately
- C. Try to rouse her by giving her coffee
- D. Give her sweetened orange juice
Correct Answer: B
Rationale: Fruity breath, unconsciousness, and symptoms of polyphagia, polydipsia, and vomiting suggest diabetic ketoacidosis, requiring immediate hospital care.
The nurse is administering a pancreatic enzyme to the client diagnosed with chronic pancreatitis. Which statement best explains the rationale for administering this medication?
- A. It is an exogenous source of protease, amylase, and lipase.
- B. This enzyme increases the number of bowel movements.
- C. This medication breaks down in the stomach to help with digestion.
- D. Pancreatic enzymes help break down fat in the small intestine.
Correct Answer: A
Rationale: Pancreatic enzymes provide protease, amylase, and lipase to compensate for pancreatic insufficiency, aiding digestion. They don’t increase bowel movements or break down in the stomach.
The client is diagnosed with hypothyroidism. Which assessment data support this diagnosis?
- A. The client's vital signs are: T 99.0, P 110, R 26, and BP 145/80.
- B. The client complains of constipation and being constantly cold.
- C. The client has an intake of 780 mL and output of 256 mL.
- D. The client complains of a headache and has projectile vomiting.
Correct Answer: B
Rationale: Constipation and cold intolerance are classic hypothyroidism symptoms due to slowed metabolism. Tachycardia/hypertension, fluid imbalance, and vomiting are unrelated.
The nurse is planning to address diabetic meal planning with the client recently diagnosed with type 1 DM. Which action should the nurse take first?
- A. Encourage use of non-nutritive sweeteners that contain no calories.
- B. Emphasize the importance of keeping regular mealtimes every day.
- C. Teach the client how to count the carbohydrates in meals and snacks.
- D. Ask the client to identify favorite foods and the client's usual mealtimes.
Correct Answer: D
Rationale: Asking about favorite foods and usual mealtimes is an assessment question used in obtaining a thorough diet history; the nurse should take this action first prior to beginning teaching.
Which electrolyte replacement should the nurse anticipate being ordered by the health-care provider in the client diagnosed with diabetic ketoacidosis (DKA) who has just been admitted to the ICU?
- A. Glucose.
- B. Potassium.
- C. Calcium.
- D. Sodium.
Correct Answer: B
Rationale: DKA causes potassium depletion due to acidosis and diuresis; replacement is anticipated to prevent arrhythmias. Glucose is not an electrolyte, and calcium/sodium are less critical.