Nokea
Which one of the following therapies is the MOST incorporated in the management of clients with gestational diabetes?
- A. Therapeutic diet alone
- B. Long acting insulin
- C. Oral hypoglycaemics
- D. Short acting insulin
Correct Answer: D
Rationale: The correct answer is D: Short acting insulin. In gestational diabetes, short acting insulin is preferred as it provides immediate control over blood sugar levels after meals. This is crucial in managing the condition to prevent complications for both the mother and the baby. Therapeutic diet alone (choice A) may not be sufficient to control blood sugar levels, while long-acting insulin (choice B) may not provide the rapid response needed after meals. Oral hypoglycemics (choice C) are generally avoided in pregnancy due to potential risks to the fetus. Therefore, short acting insulin is the most appropriate therapy for managing gestational diabetes effectively.
You may also like to solve these questions
Lester R. is a 58-year-old male who is being evaluated for nocturia. He reports that he has to get up 2 to 3 times nightly to void. Additional assessment reveals urinary urgency and appreciable post-void dribbling. A digital rectal examination reveals a normal-sized prostate with no appreciable hypertrophy. The best approach to this patient includes
- A. Administration of the American Urological Association (AUA) Symptom Scale
- B. Laboratory assessment to include a PSA
- C. Ordering a prostate ultrasound
- D. Assessment of nonprostate causes of nocturia
Correct Answer: D
Rationale: The correct answer is D: Assessment of nonprostate causes of nocturia. In this case, the patient's symptoms of nocturia, urinary urgency, and post-void dribbling are not indicative of prostate enlargement. Given that the digital rectal examination revealed a normal-sized prostate with no hypertrophy, it is essential to explore other potential causes of nocturia in this patient. By assessing non-prostate causes of nocturia, such as diabetes, urinary tract infection, medication side effects, or sleep disorders, a more accurate diagnosis and appropriate treatment plan can be developed. This approach will lead to better patient outcomes compared to focusing solely on prostate-related evaluations.
Option A: Administration of the AUA Symptom Scale is not the best approach in this case because the patient's symptoms are not primarily related to prostate enlargement.
Option B: Laboratory assessment to include a PSA is not necessary since the digital rectal examination already indicated a normal-sized prostate with no appreciable hypertrophy.
Option C: Ordering a
The AGACNP is treating a patient with ascites. After a regimen of 200 mg of spironolactone daily, the patient demonstrates a weight loss of 0.75 kgday. The best approach to this patients management is to
- A. Continue the current regimen
- B. D/C the spironolactone and begin a loop diuretic
- C. Add a loop diuretic to the spironolactone
- D. Proceed to large-volume paracentesis
Correct Answer: A
Rationale: The correct answer is A: Continue the current regimen. Spironolactone is a potassium-sparing diuretic commonly used to treat ascites. The weight loss of 0.75 kg/day indicates that the current regimen is effective. Continuing the regimen is appropriate to avoid electrolyte imbalances. Discontinuing spironolactone (Choice B) can lead to rebound edema. Adding a loop diuretic (Choice C) may increase the risk of electrolyte disturbances. Large-volume paracentesis (Choice D) is reserved for cases of refractory ascites.
The main feature of Hyperemesis gravidarum is
- A. Pallor or cyanosis of mucous membrane
- B. Inability to eat or retain food all through
- C. Weakness because of severe state of shock
- D. Smaller fundal height compared to dates
Correct Answer: B
Rationale: Step 1: Hyperemesis gravidarum is characterized by severe nausea and vomiting during pregnancy.
Step 2: Inability to eat or retain food all through is a hallmark feature due to excessive vomiting.
Step 3: This leads to dehydration, electrolyte imbalances, and weight loss.
Step 4: Pallor, cyanosis, weakness, and smaller fundal height are not specific to hyperemesis gravidarum.
Summary: Choice B is correct as it directly relates to the primary symptom of excessive vomiting in hyperemesis gravidarum, while the other choices are not specific to this condition.
A non-pharmacological measure of pain relief in labour includes
- A. Entonox
- B. Cyclothane
- C. Homeopathy
- D. Diamorphine
Correct Answer: C
Rationale: The correct answer is C: Homeopathy. Homeopathy involves using highly diluted substances to stimulate the body's natural healing processes. In labor, homeopathy can help manage pain and support relaxation. Entonox (A) and Diamorphine (D) are pharmacological measures, while Cyclothane (B) is not a recognized pain relief option in labor. Homeopathy aligns with non-pharmacological approaches, making it the most suitable choice for pain relief in labor.
Jennifer is an RN applicant for a staff nurse position in the surgical ICU. She has had a screening PPD and comes back in 48 hours to have it read. There is a 12-mm induration at the site of injection. A chest radiograph is negative. The AGACNP knows that the next step in Jennifers evaluation and management should include
- A. No further care, because the chest radiograph is negative
- B. Quantiferon serum assay for exposure
- C. Consideration of prophylactic therapy
- D. Beginning therapy for pulmonary TB pending sputum cultures
Correct Answer: C
Rationale: The correct answer is C: Consideration of prophylactic therapy. A 12-mm induration in a healthcare worker is considered positive for PPD. In the absence of active TB on chest radiograph, the next step is to consider prophylactic therapy to prevent the development of active TB. This is based on the guidelines for the management of latent TB infection. Choice A is incorrect as a positive PPD warrants further evaluation regardless of the chest radiograph result. Choice B, the Quantiferon assay, is not the next step after a positive PPD and negative chest radiograph. Choice D, beginning therapy for pulmonary TB pending sputum cultures, is not indicated in this scenario as there is no evidence of active TB.