Nokea
When the client asks the nurse why regular exercise is recommended for diabetic clients, the best answer is that exercise tends to facilitate which positive outcome?
- A. Regular exercise helps to control weight.
- B. Regular exercise helps to decrease appetite.
- C. Regular exercise helps to reduce blood glucose levels.
- D. Regular exercise helps to improve circulation to the feet.
Correct Answer: C
Rationale: Exercise increases insulin sensitivity, reducing blood glucose levels in diabetes.
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Based on the client's blood glucose measurement, the nurse immediately reevaluates the client. Which physician orders should the nurse anticipate? Select all that apply.
- A. STAT serum blood glucose
- B. Intravenous regular insulin
- C. Vital signs every 2 hours
- D. A diet of six small, frequent meals
- E. Electronic glucometer measurements before meals and at bedtime
- F. Continuous cardiac monitoring
Correct Answer: A,B,E,F
Rationale: DKA with a glucose of 498 mg/dL requires STAT serum glucose, IV insulin, frequent glucometer checks, and cardiac monitoring.
The client is hospitalized with a tentative diagnosis of Cushing's syndrome. Which laboratory findings should the nurse expect if the diagnosis of Cushing's syndrome is confirmed? Select all that apply.
- A. Hyperglycemia
- B. Eosinophilia
- C. Hypocalcemia
- D. Hypokalemia
- E. Thrombocytopenia
- F. Elevated serum cortisol
Correct Answer: A,D,F
Rationale: Cushing's syndrome causes hyperglycemia, hypokalemia, and elevated serum cortisol due to excessive adrenocortical activity.
The home health nurse is admitting a client diagnosed with cancer of the pancreas. Which information is the most important for the nurse to discuss with the client?
- A. Determine the client's food preferences.
- B. Ask the client if there is an advance directive.
- C. Find out about insurance/Medicare reimbursement.
- D. Explain the client should eat as much as possible.
Correct Answer: B
Rationale: An advance directive is critical for pancreatic cancer due to poor prognosis, ensuring the client’s wishes are respected. Food preferences, insurance, and eating are secondary.
The nurse is teaching a client to self-administer insulin. The instructions should include teaching the client to:
- A. inject the needle at a 90-degree angle into the muscle.
- B. vigorously massage the area after injecting the insulin.
- C. rotate injection sites.
- D. keep the open bottle of insulin in the refrigerator.
Correct Answer: C
Rationale: Rotating injection sites prevents lipodystrophy and ensures consistent insulin absorption. Insulin is injected subcutaneously, not into muscle, and massaging can alter absorption.
The nurse is assessing the client who has type 2 DM. Which findings indicate to the nurse that the client is experiencing HHNS? Select all that apply.
- A. Serum osmolality 364 mOsm/kg
- B. Blood glucose level 160 mg/dL
- C. Very dry mucous membranes
- D. Blood pressure of 90/42 mm Hg
- E. Urine output 500 mL past 8 hours
Correct Answer: A,C,D
Rationale: A serum osmolality of 364 mOsm/kg, very dry mucous membranes, and a BP of 90/42 indicate HHNS due to elevated osmolality, dehydration, and hypotension from osmotic diuresis.