Nokea
Which instruction should the nurse give the client about insulin administration during periods of illness?
- A. Monitor blood glucose levels every 2 to 4 hours.
- B. Eat candy or sugar frequently.
- C. Attempt to drink a high-calorie beverage every hour.
- D. Test urine daily for protein.
Correct Answer: A
Rationale: Frequent blood glucose monitoring during illness helps adjust insulin doses to prevent complications.
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The charge nurse is making client assignments in the intensive care unit. Which client should be assigned to the most experienced nurse?
- A. The client with type 2 diabetes who has a blood glucose level of 348 mg/dL.
- B. The client diagnosed with type 1 diabetes who is experiencing hypoglycemia.
- C. The client with DKA who has multifocal premature ventricular contractions.
- D. The client with HHNS who has a plasma osmolarity of 290 mOsm/L.
Correct Answer: C
Rationale: DKA with PVCs indicates cardiac instability, requiring an experienced nurse for complex monitoring and intervention. High glucose, hypoglycemia, and normal osmolarity are less critical.
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.
If a regular diet is ordered, which between-meal snack should the nurse offer to help regulate the client's blood glucose level?
- A. A small carton of milk
- B. A small apple
- C. A handful of raisins
- D. A slice of bread
Correct Answer: A
Rationale: A small carton of milk provides a balance of carbohydrates and protein to stabilize blood glucose in hypoglycemia.
The client is admitted to the intensive care department diagnosed with myxedema coma. Which assessment data warrant immediate intervention by the nurse?
- A. Serum blood glucose level of 74 mg/dL.
- B. Pulse oximeter reading of 90%.
- C. Telemetry reading showing sinus bradycardia.
- D. The client is lethargic and sleeps all the time.
Correct Answer: B
Rationale: A pulse oximetry of 90% indicates hypoxia, requiring immediate intervention in myxedema coma. Normal glucose, bradycardia, and lethargy are expected.
The client diagnosed with type 1 diabetes is found lying unconscious on the floor of the bathroom. Which intervention should the nurse implement first?
- A. Administer 50% dextrose (IVP).
- B. Notify the health-care provider.
- C. Move the client to the ICU.
- D. Check the serum glucose level.
Correct Answer: D
Rationale: Checking glucose confirms hypoglycemia or hyperglycemia as the cause of unconsciousness, guiding treatment. Dextrose, HCP notification, or ICU transfer follow confirmation.