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Which arterial blood gas results should the nurse expect in the client diagnosed with diabetic ketoacidosis?
- A. pH 7.34, PaO2 99, PaCO2 48, HCO3 24.
- B. pH 7.38, PaO2 95, PaCO2 40, HCO3 22.
- C. pH 7.46, PaO2 85, PaCO2 30, HCO3 26.
- D. pH 7.30, PaO2 90, PaCO2 30, HCO3 18.
Correct Answer: D
Rationale: DKA causes metabolic acidosis (low pH 7.30, low HCO3 18) with compensatory respiratory alkalosis (low PaCO2 30). Other options show normal or alkalotic states.
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Which nursing care measure is essential because a client has exophthalmos?
- A. Administer artificial tears.
- B. Encourage the client to wear her glasses.
- C. Promote bed rest.
- D. Monitor her pulse rate every four hours.
Correct Answer: A
Rationale: Exophthalmos (bulging eyes) in hyperthyroidism causes dry eyes, requiring artificial tears to prevent corneal damage.
Which interrelated concepts could be identified as actual or potential for a 56-year-old male client diagnosed with diabetes mellitus type 2? Select all that apply.
- A. Nutrition.
- B. Metabolism.
- C. Infection.
- D. Male reproduction.
- E. Skin integrity.
Correct Answer: A,B,C,E
Rationale: Nutrition, metabolism, infection, and skin integrity are impacted by type 2 diabetes due to dietary needs, glucose control, infection risk, and neuropathy. Male reproduction is less directly affected.
The client is diagnosed with acute pancreatitis. Which health-care provider's admitting order should the nurse question?
- A. Bedrest with bathroom privileges.
- B. Initiate IV therapy of D5W at 125 mL/hr.
- C. Weigh the client daily.
- D. Low-fat, low-carbohydrate diet.
Correct Answer: D
Rationale: A low-fat, low-carb diet is inappropriate during acute pancreatitis; clients are typically NPO to rest the pancreas. Bedrest, IV D5W, and weighing are appropriate.
Which laboratory test is most important for the nurse to monitor to determine how effectively the client's diabetes is being managed?
- A. Fasting blood glucose
- B. Blood chemistry profile
- C. Complete blood count
- D. Glycosylated hemoglobin (HbA1c)
Correct Answer: D
Rationale: HbA1c reflects average blood glucose control over 2-3 months, indicating long-term diabetes management.
The client with type 1 DM is scheduled for major surgery in the morning. The nurse on the night shift observes that the client's daily insulin dose remains the same as previously given. Which nursing action is most appropriate?
- A. Notify the prescribing HCP about the client's surgery and ask about any insulin changes.
- B. Write an order to decrease the morning insulin dose by one-half of the prescribed dose.
- C. Do nothing; the HCP would want the client to receive the usual insulin dose prior to surgery.
- D. Have the day shift nurse check a morning glucose level and, if normal, hold the insulin dose.
Correct Answer: A
Rationale: Because the client will be NPO for surgery, the nurse should verify the insulin type and dose to be administered to prevent a hypoglycemic reaction.