Nokea
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.
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Which statement by the client provides the best evidence that the client understands the principle of an exchange list for meal planning?
- A. I can eat one serving from each category on the exchange list per day.
- B. I record the patient's disease of food in each category are equal to one another.
- C. The number of servings from the exchange list is unlimited.
- D. I need to use the exchange list to determine the nutrition in food.
Correct Answer: B
Rationale: The exchange list groups foods with similar nutritional content, allowing equivalent substitutions.
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.
When the nurse conducts an admission history, which subjective symptom is the client likely to describe?
- A. Difficulty urinating
- B. Intolerance to cold
- C. Profuse perspiration
- D. Excessive appetite
Correct Answer: B
Rationale: Intolerance to cold is a common symptom of myxedema due to decreased metabolic rate.
The nurse is preparing to discharge the client following a unilateral adrenalectomy to treat hyperaldosteronism caused by an adenoma. Which instruction should be included in this client's discharge teaching?
- A. Avoid foods high in potassium
- B. Self-monitor blood pressure daily
- C. Stop drugs taken before adrenalectomy
- D. Carry epinephrine for emergency use
Correct Answer: B
Rationale: Self-monitoring BP is necessary as hypertension may persist in 20% of clients post-adrenalectomy.
Which assessment data indicate the client diagnosed with diabetic ketoacidosis is responding to the medical treatment?
- A. The client has tented skin turgor and dry mucous membranes.
- B. The client is alert and oriented to date, time, and place.
- C. The client's ABG results are pH 7.29, PaCO2 44, HCO3 15.
- D. The client's serum potassium level is 3.3 mEq/L.
Correct Answer: B
Rationale: Alertness and orientation indicate resolving DKA, as cerebral function improves. Persistent dehydration, acidosis (pH 7.29), and hypokalemia are not signs of improvement.