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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.
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To reduce or eliminate the symptoms that a client with functional hypoglycemia experiences, it is best for the nurse to recommend eating five or six small meals containing which nutrient?
- A. Simple sugars
- B. Complete proteins
- C. Complex carbohydrates
- D. Unsaturated fats
Correct Answer: C
Rationale: Complex carbohydrates provide a steady glucose release, preventing hypoglycemic episodes.
Before the client is discharged, the physician orders lypressin (Diapid) to be administered p.r.n. When instructing the client about how to take this drug at home, the nurse tells the client to administer the drug when experiencing which sign or symptom?
- A. Increased thirst
- B. Onset of a headache
- C. Dark yellow urine
- D. A runny nose
Correct Answer: A
Rationale: Increased thirst is a symptom of diabetes insipidus indicating the need for lypressin to control fluid loss.
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.
The client is three (3) days postoperative unilateral adrenalectomy. Which discharge instructions should the nurse teach?
- A. Discuss the need for lifelong steroid replacement.
- B. Instruct the client on administration of vasopressin.
- C. Teach the client to care for the suprapubic Foley catheter.
- D. Tell the client to notify the HCP if the incision is inflamed.
Correct Answer: D
Rationale: Notifying the HCP for incision inflammation prevents infection post-adrenalectomy. Lifelong steroids are for bilateral procedures, vasopressin is for DI, and Foley catheters are not standard.
The nurse is reviewing serum laboratory results for four female clients. Place an X on the client requiring the most immediate assessment.
- A. Client A: TSH 5.2 mIU/L, Free T4 0.8 ng/dL
- B. Client B: GH 23 µg/L, IGF-I 490 ng/mL
- C. Client C: Free T4 7.0 ng/dL, TSH 0.1 mIU/L
- D. Client D: Fasting glucose 140 mg/dL, Hgb A1c 6.9%
Correct Answer: C
Rationale: Client C has elevated free T4 and decreased TSH, indicating hyperthyroidism, which can lead to life-threatening thyroid storm with severe hypertension and tachycardia, requiring immediate assessment.