Nokea
The nurse teaches the client with newly diagnosed diabetes mellitus about the signs and symptoms of hypoglycemia. Which of the following should the nurse stress in teaching? Select all that apply.
- A. Sleepiness
- B. Shallow
- C. Thirst
- D. Hunger
- E. Diaphoresis
- F. Confusion
Correct Answer: D,E,F
Rationale: Hypoglycemia causes hunger, diaphoresis, and confusion due to low blood glucose affecting the brain and body.
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Which nursing instruction should the nurse discuss with the client who is receiving glucocorticoids for Addison’s disease?
- A. Discuss the importance of tapering medications when discontinuing medication.
- B. Explain the dose may need to be increased during times of stress or infection.
- C. Instruct the client to take medication on an empty stomach with a glass of water.
- D. Encourage the client to wear clean white socks when wearing tennis shoes.
Correct Answer: B
Rationale: Addison’s disease requires glucocorticoid replacement, and doses must be increased during stress or infection to mimic the body’s natural cortisol response and prevent adrenal crisis. Tapering applies to exogenous steroid cessation, empty stomach intake is incorrect, and socks are irrelevant.
Which laboratory data make the nurse suspect the client with primary hyperparathyroidism is experiencing a complication?
- A. A serum creatinine level of 2.8 mg/dL.
- B. A calcium level of 9.2 mg/dL.
- C. A serum triglyceride level of 130 mg/dL.
- D. A sodium level of 135 mEq/L.
Correct Answer: A
Rationale: Elevated creatinine (2.8 mg/dL) suggests kidney damage, a complication of hyperparathyroidism’s hypercalcemia. Normal calcium, triglycerides, and sodium are unremarkable.
The nurse is reviewing information for the client with type 1 DM. The nurse concludes that the client may be experiencing the Somogyi phenomenon, as evidenced by which finding?
- A. 02:00 blood glucose between 80-110 mg/dL and morning levels between 80-100 mg/dL
- B. 02:00 blood glucose between 50-60 mg/dL and morning levels between 48-62 mg/dL
- C. 02:00 blood glucose between 130-140 mg/dL and morning levels between 180-200 mg/dL
- D. 02:00 blood glucose between 45-62 mg/dL and morning levels between 200-305 mg/dL
Correct Answer: D
Rationale: The nurse should conclude that the low blood glucose in the middle of the night (45-62 mg/dL) and a rebound morning hyperglycemia (200-305 mg/dL) are signs of Somogyi phenomenon, also known as Somogyi effect.
When directing the nursing assistant to weigh the client, which instruction is most important for obtaining accurate data?
- A. Have the client stand on a bedside scale.
- B. Weigh the client at the same time each day.
- C. Ask that slippers be removed when being weighed.
- D. Ask about the client's pre-disease weight.
Correct Answer: B
Rationale: Weighing the client at the same time each day ensures consistency and accounts for daily fluctuations in weight due to meals, hydration, or other factors.
The UAP on the medical floor tells the nurse the client diagnosed with DKA wants something else to eat for lunch. Which intervention should the nurse implement?
- A. Instruct the UAP to get the client additional food.
- B. Notify the dietitian about the client's request.
- C. Request the HCP increase the client's caloric intake.
- D. Tell the UAP the client cannot have anything else.
Correct Answer: B
Rationale: Notifying the dietitian ensures the client’s nutritional needs are met within DKA dietary restrictions. Additional food, caloric increases, or denial are inappropriate without consultation.