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Which information should the nurse include when developing a teaching plan for a client newly diagnosed with type 2 diabetes mellitus. Select all that apply.
- A. A major risk factor for complications is obesity and central abdominal obesity.
- B. Supplemental insulin is mandatory for controlling the disease.
- C. Exercise increases insulin resistance.
- D. The primary nutritional source requiring monitoring in the diet is carbohydrates.
- E. Annual eye and foot examinations are recommended by the American Diabetes Association (ADA).
Correct Answer: A,D,E
Rationale: Obesity, especially central, is a major risk factor for complications. Carbohydrates require monitoring to manage blood glucose. Annual eye and foot exams are recommended. Insulin is not mandatory for type 2 diabetes, and exercise decreases insulin resistance.
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The nurse finds it difficult to relieve a client's pain satisfactorily. Which of the following measures should the nurse take next when continuing efforts to promote comfort?
- A. Improve the nurse-client relationship.
- B. Enlist the help of the client's family.
- C. Allow the client additional time to work through his or her own responses to pain.
- D. Arrange to have the client share a room with a client who has little pain.
Correct Answer: A
Rationale: Improving the nurse-client relationship fosters trust, enhancing pain management through better communication and tailored interventions. Family help, time, or room sharing are less direct solutions.
Which of the following reflects the principle on which a client's diet will most likely be based during the acute phase of myocardial infarction?
- A. Liquids as desired.
- B. Small, easily digested meals.
- C. Three regular meals per day.
- D. Nothing by mouth.
Correct Answer: B
Rationale: Small, easily digested meals reduce the metabolic demand on the heart and prevent gastrointestinal distress, which could exacerbate myocardial oxygen demand during the acute phase of MI.
The nurse is observing a nursing student prepare to give an intramuscular (IM) injection in a client's deltoid. Which action by the student requires follow-up?
- A. Depresses the plunger of the syringe during the insertion of the needle
- B. Locates the injection site 3 finger widths below the acromion process
- C. Positions the client either lying or sitting position
- D. Dons clean gloves before administering the injection
Correct Answer: A
Rationale: Depressing the plunger during needle insertion can cause medication to leak into subcutaneous tissue, leading to improper administration and potential tissue damage.
A client with a surgical wound reports itching around the incision site on postoperative day 5. The nurse should:
- A. Apply an antihistamine cream.
- B. Assess the wound for signs of infection.
- C. Instruct the client to avoid scratching.
- D. Clean the wound with alcohol.
Correct Answer: C
Rationale: Itching is common during healing, but scratching can disrupt the incision. Instructing the client to avoid scratching prevents wound dehiscence while further assessment can rule out infection.
The nurse should assess a client with thrombocytopenia who has developed a hemorrhage for which of the following?
- A. Tachycardia.
- B. Bradycardia.
- C. Decreased urine output.
- D. Hypotension.
Correct Answer: A
Rationale: Hemorrhage in a client with thrombocytopenia can lead to hypovolemia, causing tachycardia as the heart compensates for decreased blood volume. Bradycardia is not typical, and while decreased urine output and hypotension may occur later, tachycardia is an earlier and more immediate sign.