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Which signs/symptoms should the nurse expect to assess in the client diagnosed with an insulinoma?
- A. Nervousness, jitteriness, and diaphoresis.
- B. Flushed skin, dry mouth, and tented skin turgor.
- C. Polyuria, polydipsia, and polyphagia.
- D. Hypertension, tachycardia, and feeling hot.
Correct Answer: A
Rationale: An insulinoma is a pancreatic tumor causing excessive insulin secretion, leading to hypoglycemia. Symptoms include nervousness, jitteriness, and diaphoresis (Whipple’s triad). Flushed skin and dehydration suggest hyperglycemia, polyuria/polydipsia/polyphagia are diabetes symptoms, and hypertension/tachycardia are more typical of pheochromocytoma.
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Which respiratory pattern is the best description of the client's breathing?
- A. Fast, deep, labored respirations
- B. Shallow respirations, alternating with apnea
- C. Slow inhalation and exhalation through pursed lips
- D. Shortness of breath with pauses
Correct Answer: A
Rationale: Kussmaul's respirations in DKA are fast, deep, and labored to compensate for metabolic acidosis.
The client is admitted to the medical department with a diagnosis of rule-out (R/O) acute pancreatitis. Which laboratory values should the nurse monitor to confirm this diagnosis?
- A. Creatinine and (BUN).
- B. Troponin and (CK-MB).
- C. Serum amylase and lipase.
- D. Serum bilirubin and calcium.
Correct Answer: C
Rationale: Elevated amylase and lipase are specific for acute pancreatitis, confirming the diagnosis. Creatinine/BUN, troponin/CK-MB, and bilirubin/calcium are unrelated.
The 68-year-old client diagnosed with hyperthyroidism is being treated with radioactive iodine therapy. Which interventions should the nurse discuss with the client?
- A. Explain it will take up to a month for symptoms of hyperthyroidism to subside.
- B. Teach the iodine therapy will have to be tapered slowly over one (1) week.
- C. Discuss the client will have to be hospitalized during the radioactive therapy.
- D. Inform the client after therapy the client will not have to take any medication.
Correct Answer: A
Rationale: Radioactive iodine takes weeks to reduce hyperthyroid symptoms, requiring client understanding. Tapering, hospitalization, and stopping medications are incorrect.
When developing the client's care plan, which intervention is most appropriate to add?
- A. Encourage the client to use an electric razor.
- B. Tell the client to file rather than cut toenails.
- C. Make sure that the client receives mouth care twice per day.
- D. Advise the client to use deodorant soap when bathing.
Correct Answer: B
Rationale: Filing toenails prevents injury and infection in diabetic clients with poor healing.
The client taking NPH insulin at 0800 reports feeling anxious and shaky in the midafternoon. Which intervention is best for the nurse to initiate?
- A. Have the client rate the level of anxiety.
- B. Give the client's prn dose of lorazepam.
- C. Check the client's fingerstick blood glucose level.
- D. Advise the client to sit in a recliner to relax.
Correct Answer: C
Rationale: The best intervention is to check a fingerstick blood glucose level because anxiety and shakiness in the midafternoon when taking NPH insulin could indicate hypoglycemia; NPH insulin peaks in 6-8 hours after administration.