Nokea
The nurse is teaching the client diagnosed with hyperthyroidism. Which information should be taught to the client? Select all that apply.
- A. Notify the HCP if a three (3)-pound weight loss occurs in two (2) days.
- B. Discuss ways to cope with the emotional lability.
- C. Notify the HCP if taking over-the-counter medication.
- D. Carry a medical identification card or bracelet.
- E. Teach how to take thyroid medications correctly.
Correct Answer: B,C,D
Rationale: Coping with emotional lability, reporting OTC meds, and carrying ID address hyperthyroidism’s effects and safety. Rapid weight loss is expected, and thyroid meds are for hypothyroidism.
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The nurse administers 15 units of glargine insulin at 2100 hours to the client when the client's fingerstick blood glucose reading is 110 mg/dL. At 2300, an NA reports that an evening snack was not given because the client was sleeping. Which instruction by the nurse is most appropriate?
- A. You will need to wake the client to check the blood glucose and then give a snack. All diabetics get a snack at bedtime.'
- B. It is not necessary for this client to have a snack; glargine insulin is absorbed over 24 hours and doesn't have a peak.'
- C. The next time the client wakes up, check a blood glucose level and then give a 15-gram carbohydrate snack.'
- D. I will notify the HCP; a snack at this time will affect the next blood glucose level and dose of glargine insulin.'
Correct Answer: B
Rationale: The onset of glargine is 1 hour; it has no peak action, and it lasts for 24 hours. Because it has no peak action, a bedtime snack is unnecessary.
A client is admitted to the hospital with recently diagnosed Type I diabetes mellitus and is to have fasting blood work drawn this morning. At 7:00 A.M., the lab has not arrived to draw the blood. The client's dose of regular insulin is scheduled for 7:30 A.M. What is the best action for the nurse to take?
- A. Give the insulin as ordered
- B. Withhold the insulin until the lab comes and the client will be eating within 15 to 30 minutes
- C. Withhold the insulin until the blood has been drawn and the client has eaten
- D. Do not administer insulin until the blood work has been drawn and the results have been called back to the unit
Correct Answer: C
Rationale: Withholding insulin until blood is drawn and the client has eaten prevents hypoglycemia during fasting blood work.
An 18-year-old female client, 5'4 tall, weighing 113 kg, comes to the clinic for a nonhealing wound on her lower leg, which she has had for two (2) weeks. Which disease process should the nurse suspect the client has developed?
- A. Type 1 diabetes.
- B. Type 2 diabetes.
- C. Gestational diabetes.
- D. Acanthosis nigricans.
Correct Answer: B
Rationale: Obesity (BMI ~44) and a nonhealing wound suggest type 2 diabetes, associated with insulin resistance. Type 1 is less likely, gestational diabetes requires pregnancy, and acanthosis nigricans is a symptom, not a disease.
A client is diagnosed as having insulin-dependent diabetes mellitus (IDDM). She received regular insulin at 7:30 A.M. When is she most apt to develop a hypoglycemic reaction?
- A. Mid-morning
- B. Mid-afternoon
- C. Early evening
- D. During the night
Correct Answer: A
Rationale: Regular insulin peaks 2-4 hours after administration, making mid-morning (9:30-11:30 A.M.) the most likely time for hypoglycemia.
The nurse is teaching the client diagnosed with type 2 diabetes mellitus about diet. Which diet selection indicates the client understands the teaching?
- A. A submarine sandwich, potato chips, and diet cola.
- B. Four (4) slices of a supreme thin-crust pizza and milk.
- C. Smoked turkey sandwich, celery sticks, and unsweetened tea.
- D. A roast beef sandwich, fried onion rings, and a cola.
Correct Answer: C
Rationale: A turkey sandwich, celery, and unsweetened tea are low-carb, low-fat, and diabetes-friendly. Other options are high in carbs or fats, worsening glycemic control.