Nokea
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.
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The nurse completes teaching the client with Cushing's disease. Which statement demonstrates that the client understands measures to prevent bone resorption from corticosteroid therapy?
- A. I will increase calcium in my diet to 3000 mg daily.'
- B. I should participate in daily weight-bearing exercises.'
- C. I should limit my dietary intake of sodium and vitamin D.'
- D. I plan to rise slowly from a bed or chair to avoid falling.'
Correct Answer: B
Rationale: Daily weight-bearing exercises can help prevent bone loss and strengthen bones and muscles.
The client with type 2 DM is scheduled for cardiac rehabilitation exercises (cardiac rehab). The nurse notes that the client's blood glucose level is 300 mg/dL and that the urine is positive for ketones. How should the nurse proceed?
- A. Send the client to cardiac rehab; exercise will lower the client's glucose level.
- B. Give insulin; send the client for exercises with a 15-gram carbohydrate snack.
- C. Delay cardiac rehab; blood glucose levels will decrease too much with exercise.
- D. Cancel cardiac rehab; blood glucose levels will increase further with exercise.
Correct Answer: D
Rationale: Exercising with blood glucose levels exceeding 250 mg/dL and ketonuria increases the secretion of glucagon, growth hormone, and catecholamines, causing the liver to release more glucose.
The nurse discusses the long-term effects of diabetes mellitus with the client and realizes that the client needs further teaching when the client identifies which occurrence as a complication of this disease?
- A. Blindness
- B. Stroke
- C. Renal failure
- D. Liver failure
Correct Answer: D
Rationale: Liver failure is not a common complication of diabetes, unlike blindness, stroke, and renal failure.
An adult with myxedema is started on thyroid replacement therapy and is discharged. The client returns to the doctor's office one week later. Which statement that the client makes is most indicative of an adverse reaction to the medication?
- A. My chest hurt when I was sweeping the floor this morning.'
- B. I had severe cramps last night.'
- C. I am losing weight.'
- D. My pulse rate has been more rapid lately.'
Correct Answer: A
Rationale: Chest pain during activity suggests angina, a potential adverse effect of thyroid replacement therapy due to increased metabolic demand.
The nurse is planning a program for clients at a health fair regarding the prevention and early detection of cancer of the pancreas. Which self-care activity should the nurse discuss as an example of a primary nursing intervention?
- A. Monitor for elevated blood glucose at random intervals.
- B. Inspect the skin and sclera of the eyes for a yellow tint.
- C. Limit meat in the diet and eat a diet low in fat.
- D. Instruct the client with hyperglycemia about insulin injections.
Correct Answer: C
Rationale: A low-fat diet reduces pancreatic stress, a primary prevention strategy. Glucose monitoring, jaundice inspection, and insulin teaching are secondary or tertiary.