The nurse obtains a fingerstick blood glucose reading of 48 mg/dL for the client with type 1 DM. The client is to receive 6 units of regular and 10 units of NPH insulin now. Which is the nurse's best immediate intervention?
- A. Administer the insulin that is due now.
- B. Call the lab for a STAT serum glucose level.
- C. Have the client choose foods for a meal now.
- D. Provide juice with 15 grams of carbohydrates.
Correct Answer: D
Rationale: Hypoglycemia is treated with 15 to 20 g of a simple (fast-acting) carbohydrate, such as 4 to 6 oz of fruit juice or 8 oz of low-fat milk.
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The nurse administered 28 units of Humulin N, an intermediate-acting insulin, to a client diagnosed with type 1 diabetes at 1600. Which intervention should the nurse implement?
- A. Ensure the client eats the bedtime snack.
- B. Determine how much food the client ate at lunch.
- C. Perform a glucometer reading at 0700.
- D. Offer the client protein after administering insulin.
Correct Answer: A
Rationale: Humulin N peaks in 4–12 hours, risking nocturnal hypoglycemia. A bedtime snack prevents this. Lunch intake is irrelevant, morning glucose checks are too late, and protein alone is insufficient.
Which laboratory data indicate to the nurse the client’s pancreatitis is improving?
- A. The amylase and lipase serum levels are decreased.
- B. The white blood cell (WBC) count is decreased.
- C. The conjugated and unconjugated bilirubin levels are decreased.
- D. The blood urea nitrogen (BUN) serum level is decreased.
Correct Answer: A
Rationale: Acute pancreatitis is characterized by elevated serum amylase and lipase levels due to pancreatic inflammation. A decrease in these levels indicates reduced pancreatic injury and improvement in the condition. While a decreased WBC count may suggest resolving infection, it is less specific. Bilirubin levels are relevant for biliary obstruction, not pancreatitis improvement, and BUN reflects renal function, not pancreatic status.
The client develops SIADH secondary to a pituitary tumor. The client's assessment findings include thirst, weight gain, fatigue, and a serum sodium of 127 mEq/L. Which intervention, if prescribed, should the nurse implement to treat SIADH?
- A. Elevate the head of the bed 30 degrees
- B. Administer vasopressin intravenously (IV)
- C. Restrict fluids to 800 to 1000 mL per day
- D. Give 0.3% sodium chloride IV infusion
Correct Answer: C
Rationale: Fluid restriction to 800-1000 mL/day treats mild SIADH with serum sodium >125 mEq/L by raising sodium concentration.
Which laboratory test is most important for the nurse to monitor to determine how effectively the client's diabetes is being managed?
- A. Fasting blood glucose
- B. Blood chemistry profile
- C. Complete blood count
- D. Glycosylated hemoglobin (HbA1c)
Correct Answer: D
Rationale: HbA1c reflects average blood glucose control over 2-3 months, indicating long-term diabetes management.
Because propylthiouracil (Propyl-Thyracil) can cause agranulocytosis, the nurse advises the client to notify the physician's health problem occurs?
- A. Persistent sore throat
- B. Occasional heart palpitations
- C. Fatigue on exertion
- D. Prolonged bleeding with trauma
Correct Answer: A
Rationale: Agranulocytosis, a side effect of propylthiouracil, can manifest as a persistent sore throat due to decreased white blood cells.
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