Nokea
When the client asks why a diabetic relative cannot take insulin orally, what is the best answer?
- A. Insulin is inactivated by digestive enzymes.
- B. Insulin is absorbed too quickly in the stomach.
- C. Insulin is irritating to the gastric mucosa.
- D. Insulin is incompatible with many foods.
Correct Answer: A
Rationale: Insulin is a protein that is broken down by digestive enzymes, rendering it ineffective if taken orally.
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An 18-year-old female client, 5'4 tall, weighing 113 kg, comes to the clinic for a nonhealing wound on her lower leg, which she has had for two (2) weeks. Which disease process should the nurse suspect the client has developed?
- A. Type 1 diabetes.
- B. Type 2 diabetes.
- C. Gestational diabetes.
- D. Acanthosis nigricans.
Correct Answer: B
Rationale: Obesity (BMI ~44) and a nonhealing wound suggest type 2 diabetes, associated with insulin resistance. Type 1 is less likely, gestational diabetes requires pregnancy, and acanthosis nigricans is a symptom, not a disease.
The nurse is caring for the client with elevated growth hormone (GH) levels. Which problem should the nurse exclude from the plan of care?
- A. Fluid volume deficit due to polyuria
- B. Insomnia due to soft tissue swelling
- C. Impaired communication due to speech difficulties
- D. Altered body image due to undersized hands, feet, and jaw
Correct Answer: D
Rationale: GH excess causes overgrowth of bones and soft tissues, not undersizing, so altered body image due to undersized features is excluded.
The nurse identified a concept of metabolism for a client diagnosed with diabetes mellitus type 2. Which interventions should the nurse include in the plan of care? Select all that apply.
- A. Teach the client to perform self glucose monitoring.
- B. Instruct the client about complications of high-glucose levels.
- C. Instruct the client to inspect the feet daily.
- D. Explain the need to carry a source of quick-acting proteins.
- E. Encourage the client to have regular eye exams.
Correct Answer: A,B,C,E
Rationale: Glucose monitoring, complication education, foot inspections, and eye exams manage type 2 diabetes and prevent complications. Quick-acting proteins are incorrect; carbohydrates treat hypoglycemia.
What is the nursing priority when administering care to a client with severe hyperthyroidism?
- A. Assess for recent emotional trauma.
- B. Provide a calm, nonstimulating environment.
- C. Provide diversionary activity.
- D. Encourage range-of-motion exercises.
Correct Answer: B
Rationale: A calm, nonstimulating environment reduces hyperactivity and stress in hyperthyroidism, which exacerbates symptoms.
Which documentation finding provides the best indication that the client has successfully avoided an adrenal (addisonian) crisis after surgery?
- A. The client's pedal edema has lessened.
- B. Capillary blood glucose level is within normal limits.
- C. Vital signs are within preoperative ranges.
Correct Answer: C
Rationale: Stable vital signs indicate the absence of adrenal crisis, characterized by hypotension and shock.