Nokea
Which nursing instruction should the nurse discuss with the client who is receiving glucocorticoids for Addison’s disease?
- A. Discuss the importance of tapering medications when discontinuing medication.
- B. Explain the dose may need to be increased during times of stress or infection.
- C. Instruct the client to take medication on an empty stomach with a glass of water.
- D. Encourage the client to wear clean white socks when wearing tennis shoes.
Correct Answer: B
Rationale: Addison’s disease requires glucocorticoid replacement, and doses must be increased during stress or infection to mimic the body’s natural cortisol response and prevent adrenal crisis. Tapering applies to exogenous steroid cessation, empty stomach intake is incorrect, and socks are irrelevant.
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The nurse manager of a medical-surgical unit is asked to determine if the unit should adopt a new care delivery system. Which behavior is an example of an autocratic style of leadership?
- A. Call a meeting and educate the staff on the new delivery system being used.
- B. Organize a committee to investigate the various types of delivery systems.
- C. Wait until another unit has implemented the new system and see if it works out.
- D. Discuss with the nursing staff if a new delivery system should be adopted.
Correct Answer: A
Rationale: An autocratic leader unilaterally decides and informs staff, as in educating them on a chosen system. Committees, waiting, and staff discussions are democratic or laissez-faire.
The nurse completes teaching the client with Cushing's disease. Which statement demonstrates that the client understands measures to prevent bone resorption from corticosteroid therapy?
- A. I will increase calcium in my diet to 3000 mg daily.'
- B. I should participate in daily weight-bearing exercises.'
- C. I should limit my dietary intake of sodium and vitamin D.'
- D. I plan to rise slowly from a bed or chair to avoid falling.'
Correct Answer: B
Rationale: Daily weight-bearing exercises can help prevent bone loss and strengthen bones and muscles.
The UAP on the medical floor tells the nurse the client diagnosed with DKA wants something else to eat for lunch. Which intervention should the nurse implement?
- A. Instruct the UAP to get the client additional food.
- B. Notify the dietitian about the client's request.
- C. Request the HCP increase the client's caloric intake.
- D. Tell the UAP the client cannot have anything else.
Correct Answer: B
Rationale: Notifying the dietitian ensures the client’s nutritional needs are met within DKA dietary restrictions. Additional food, caloric increases, or denial are inappropriate without consultation.
An elderly client with Type 2 diabetes mellitus develops an ingrown toenail. What is the best action for the nurse to take?
- A. Put cotton under the nail and clip the nail straight across
- B. Elevate the foot immediately
- C. Apply warm, moist soaks
- D. Notify the physician
Correct Answer: D
Rationale: An ingrown toenail in a diabetic client risks infection and poor healing, requiring physician evaluation rather than self-treatment.
The clinic nurse is evaluating the client with type 1 DM who intends to enroll in a tennis class. Which statement made by the client indicates that the client understands the effects of exercise on insulin demand?
- A. I will carry a high-fat, high-calorie food, such as a cookie.'
- B. I will administer 1 unit of lispro insulin prior to playing tennis.'
- C. I will eat a 15-gram carbohydrate snack before playing tennis.'
- D. I will need to rest for a while during tennis if I feel sweaty or shaky.'
Correct Answer: C
Rationale: Excessive exercise without sufficient carbohydrates can result in unexpected hypoglycemia.