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The nurse observes the client self-administering the medication. Which action indicates that the client is using the medication correctly?
- A. The client shakes the medication vigorously
- B. The client's head is tilted to the side.
- C. The client inverts the drug container.
- D. The client inhales with each spray.
Correct Answer: D
Rationale: For intranasal lypressin, inhaling with each spray ensures proper delivery of the medication to the nasal mucosa.
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The nurse receives orders for the newly admitted client with Addison's disease. Which orders should the nurse question with the HCP? Select all that apply.
- A. Potassium 20 mEq oral now
- B. Sodium-restricted diet of 1000 mg
- C. Serum cortisol level in early am.
- D. Obtain serum glucose level now
- E. 5% dextrose in NS at 100 mL/hr
Correct Answer: A,B
Rationale: Potassium administration and a sodium-restricted diet are inappropriate as Addison's disease causes hyperkalemia and hyponatremia.
The agitated client is hospitalized with tachycardia, dyspnea, and intermittent chest palpitations. The client's BP is 170/110 mm Hg, and HR is 130 bpm. The client's health history reveals thinning hair, recent 10-lb weight loss, increased appetite, fine hand and tongue tremors, hyperreflexic tendon reflexes, and smooth, moist skin. Which prescribed intervention should be the nurse's priority?
- A. 12-lead electrocardiogram (ECG) and cardiac enzyme levels.
- B. Obtain thyroid-stimulating hormone (TSH) and free T4 levels.
- C. Propranolol 2 mg IV q15 min or until symptoms are controlled.
- D. Propylthiouracil 600-mg oral loading dose; then 200 mg orally q4h.
Correct Answer: C
Rationale: Propranolol provides rapid symptomatic relief of thyrotoxicosis by controlling cardiac and psychomotor manifestations.
A woman with newly diagnosed Type I diabetes mellitus says she wants to have children. She asks if she will be able to have children and if they will be normal. What is the best answer for the nurse to give?
- A. Women with diabetes should not get pregnant because it is very difficult to control diabetes during pregnancy.'
- B. Babies born to diabetic mothers are very apt to have severe and noncorrectable birth defects.'
- C. You should be able to safely have a baby if you go to your doctor regularly during pregnancy.'
- D. You should consult carefully with a geneticist before getting pregnant to determine how to prevent your baby from developing diabetes.'
Correct Answer: C
Rationale: With regular medical care, women with Type 1 diabetes can have safe pregnancies, minimizing risks to the baby.
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.
Using the Dietary Exchange Plan for a 1,500 calorie diet in the chart below, which item is appropriate for the diabetic client to have in the midafternoon?
- A. An 8-oz carton of milk
- B. Two stream careers
- C. A medium apple
- D. A 2-oz slice of turkey
Correct Answer: C
Rationale: The midafternoon snack in the exchange plan includes one fruit serving, making a medium apple appropriate.