Nokea
When implementing patient teaching for a patient admitted with hyperglycemia and newly diagnosed diabetes mellitus scheduled for discharge the second day after admission, what is the priority action for the nurse?
- A. Instruct about the increased risk for cardiovascular disease.
- B. Provide detailed information about dietary control of glucose.
- C. Teach glucose self-monitoring and medication administration.
- D. Give information about the effects of exercise on glucose control.
Correct Answer: C
Rationale: The correct answer is C because teaching glucose self-monitoring and medication administration is the priority action to ensure the patient can manage their condition effectively post-discharge. This step is crucial for immediate management of hyperglycemia and newly diagnosed diabetes mellitus. Option A is incorrect as addressing cardiovascular risk can be important but not the immediate priority. Option B is important but not as urgent as self-monitoring and medication administration. Option D is also important for long-term management but not as critical as ensuring immediate control of blood glucose levels through monitoring and medication.
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What instruction should a patient with a history of hypertension be provided when being discharged with a prescription for a thiazide diuretic?
- A. Avoid foods high in potassium.
- B. Take the medication at bedtime.
- C. Monitor weight daily.
- D. Limit fluid intake to 1 liter per day.
Correct Answer: C
Rationale: Rationale:
C is correct because thiazide diuretics can cause fluid retention, leading to weight gain, which may indicate worsening heart failure or hypertension. Daily weight monitoring helps detect fluid retention early, enabling timely intervention.
Summary:
A: Incorrect. Thiazide diuretics can cause potassium loss, so avoiding potassium-rich foods is not necessary.
B: Incorrect. Taking the medication in the morning is preferred to prevent nocturia and sleep disturbances.
D: Incorrect. Fluid intake should not be limited unless advised by a healthcare provider to prevent dehydration.
Which problem in a client requires the most immediate intervention by the nurse?
- A. Finger paresthesias related to carpal tunnel syndrome.
- B. Increasing sharp pain related to compartment syndrome.
- C. Increasing burning pain related to a Morton's neuroma.
- D. Increasing sharp pain related to plantar fasciitis.
Correct Answer: B
Rationale: The correct answer is B. Compartment syndrome is a medical emergency that can lead to tissue damage and loss of limb function. Immediate intervention is crucial to prevent further complications. Finger paresthesias related to carpal tunnel syndrome (A) are not life-threatening and can be managed conservatively. Morton's neuroma (C) and plantar fasciitis (D) are painful conditions, but they do not pose an immediate threat to the client's health or limb function.
A client with liver cirrhosis is prescribed lactulose. What is the purpose of this medication?
- A. To lower blood sugar levels
- B. To reduce ammonia levels
- C. To treat liver inflammation
- D. To improve bile flow
Correct Answer: B
Rationale: Rationale: Lactulose is prescribed for liver cirrhosis to reduce ammonia levels. It works by promoting the excretion of ammonia in the stool, preventing its accumulation in the bloodstream. This helps prevent hepatic encephalopathy, a serious complication of cirrhosis. Other choices are incorrect because lactulose does not directly affect blood sugar levels, liver inflammation, or bile flow in the context of liver cirrhosis.
A client with type 1 diabetes mellitus is experiencing nausea and vomiting. What advice should the nurse give regarding insulin administration?
- A. Skip your insulin dose until you can eat.'
- B. Take your insulin as prescribed, but monitor your blood glucose closely.'
- C. Reduce your insulin dose by half.'
- D. Only take your long-acting insulin.'
Correct Answer: B
Rationale: The correct answer is B because skipping insulin can lead to dangerous complications like diabetic ketoacidosis. Taking insulin as prescribed ensures blood glucose control, preventing hyperglycemia. Monitoring blood glucose closely helps adjust doses accordingly. Choice A is incorrect as skipping insulin can be life-threatening. Choice C is incorrect as reducing insulin without proper monitoring can lead to unstable glucose levels. Choice D is incorrect as both long-acting and short-acting insulin are essential for managing type 1 diabetes.
What is the primary goal of care for a client experiencing esophageal varices secondary to liver cirrhosis?
- A. Preventing infection
- B. Controlling bleeding
- C. Reducing portal hypertension
- D. Maintaining nutritional status
Correct Answer: B
Rationale: The primary goal of care for a client with esophageal varices secondary to liver cirrhosis is to control bleeding. This is because esophageal varices can lead to life-threatening hemorrhage. By controlling bleeding, we can prevent severe complications and potentially save the client's life. Preventing infection (Choice A) is important but not the primary goal in this case. Reducing portal hypertension (Choice C) is a long-term goal and may help prevent variceal bleeding in the future, but it is not the immediate priority. Maintaining nutritional status (Choice D) is important for overall health but is not the primary goal when managing acute bleeding from esophageal varices.