Oh Sugar, Oh Honey, Honey
A nurse is caring for a client with type 1 diabetes mellitus who reports feeling shaky and having palpitations. When the nurse finds the client’s blood glucose to be 48 mg/dL on the glucometer, he should give the client which of the following?
1) Graham crackers, 2) 1sp sugar, 3) 4oz diet soda, 4) 4oz skim milk?
What are Graham crackers?
A nurse is teaching an older adult client who has diabetes mellitus about preventing the long-term complications of retinopathy and nephropathy. Which of the following instructions should the nurse include?
1) "Have an eye examination once per year."
2) "Examine your feet carefully every day."
3) "Wear compression stockings daily."
4) "Maintain stable blood glucose levels."
What is "Maintain stable blood glucose levels."
A nurse is monitoring a client who reports having chills and back pain during a blood transfusion. Which of the following actions is nurse's priority?
1) Stop the transfusion, 2) Provide warm blankets, 3) Re-check the blood for compatibility, 4) Notify the provider
What is STOP THE TRANSFUSION?
What transfusion reaction is likely occurring?
A nurse is assessing a client who has diabetes insipidus. Which of the following findings should the nurse expect?
1) dehydration, 2) fluid volume overload, 3) bradycardia, 4) polyphagia
What is dehydration?
Rationale: Diabetes insipidus causes excessive excretion of dilute urine, resulting in dehydration.
A nurse is teaching a client with Addison's taking prednisone about discontinuing the medication. The nurse should explain to the client to reduce the dose gradually to prevent which of the following adverse effects?
1) Hyperglycemia, 2) Adrenocortical insufficiency, 3) Severe dehydration, 4) Rebound pulmonary congestion
What is Adrenocortical insufficiency?
Answer Rationale:
Prednisone, a corticosteroid, is similar to cortisol, the glucocorticoid hormone produced by the adrenal glands. It relieves inflammation and is used to treat certain forms of arthritis, severe allergies, autoimmune disorders, and asthma. Administration of glucocorticoids can suppress production of glucocorticoids, and an abrupt withdrawal of the drug can lead to a syndrome of adrenal insufficiency.
A nurse is teaching a client who has diabetes mellitus about disease management. Which glycosylated hemoglobin (HbA1c) value should the nurse include in the teaching as an indicator that the client is appropriately controlling his glucose levels?
What is 1) 6.3%, 2) 7.8%, 3) 8.5%, 4) 10%?
What is 6.3%?
A nurse is teaching a client who has type 1 diabetes mellitus about foot care. Which of the following statements by the client indicates an understanding of the teaching?
1) "I'll wear sandals in warm weather."
2) "I'll put lotion between my toes after drying my feet."
3) "I'll check my feet every day for sores and bruises."
4) "I'll soak my feet in cool water every night before I go to bed."
What is "I'll check my feet every day for sores and bruises."
A nurse is obtaining a health history from a client who has iron deficiency anemia. Which of the following findings should the nurse expect?
1) fatigue, 2) confusion, 3) pain, 4) slurred speech
What is fatigue?
While assessing the client 1-day postoperative following a transphenoidal hypophysectomy, the nurse notes a large area of clear drainage seeping from the nasal packing. Which of the following should be the nurse’s initial action?
1) Document the amount of drainage., 2) Obtain a culture of the drainage, 3) Check the drainage for glucose, 4) Notify the client's provider.
What is check the drainage for glucose.
Answer Rationale:
A potential complication of hypophysectomy is cerebral spinal fluid (CSF) leakage. Fluid leakage from the nose is a sign that this complication has occurred. The first action the nurse should take using the nursing process is to assess the drainage for the presence of glucose, which would indicate that the drainage is CSF.
A nurse is teaching a client who is to begin long-term therapy with prednisone to treat rheumatoid arthritis. The nurse should instruct the client to take which of the following supplements while taking this medication?
1) Calcium and vitamin D, 2) Biotin and vitamin B2, 3) Folic acid and vitamin C, 4) Pantothenic acid and vitamin B6
What is Calcium and vitamin D?
Answer Rationale:
Long-term use of glucocorticoids, such as prednisone, places the client at risk for osteoporosis. The nurse should instruct the client to take calcium and vitamin D supplements to reduce this risk.
A nurse is caring for a client with diabetes mellitus who is prescribed regular insulin via a sliding scale. After administering the dose at 0715, the nurse should ensure the client receives breakfast at which of the following times?
1) 0720, 2) 0730, 3) 0745, or 4) 0815
What is 07:45?
A nurse is reviewing the laboratory results of a client who is at risk for developing diabetes mellitus. The nurse should recognize that which of the following results indicates the client meets the criteria for diagnosis of diabetes mellitus?
1) HbA1c 5.5%, 2) 2-hr blood glucose 170 mg/dL, 3) Fasting blood glucose 155 mg/dL , 4) Random blood glucose 195 mg/dL
What is Fasting blood glucose 155 mg/dL?
A nurse is teaching a client that has been diagnosed with iron deficiency anemia. Which of the following dietary recommendations should the nurse include in the teaching plan?
1) Yogurt and mozzarella , 2) Spinach and beef, 3) Milk and turkey slices, 4) Fish and cottage cheese
What is spinach and beef?
Rationale: Spinach and beef are high in iron and would be recommended for this client.
A nurse is assessing a client who is taking levothyroxine. The nurse should recognize that which of the following findings is a manifestation of levothyroxine overdose?
1) Insomnia, 2) Constipation, 3) Drowsiness, 4) Hypoactive deep tendon reflexes
What is insomnia?
Answer Rationale:
Levothyroxine overdose will result in manifestations of hyperthyroidism, which include insomnia, tachycardia, and hyperthermia
A nurse is caring for a client who has Addison's disease. Which of the following actions should the nurse take?
1) Teach the client about cortisol replacement therapy., 2) Place the client on a low-sodium diet, 3)Monitor the client for fluid volume excess, 4) Discuss the manifestations of hyperglycemia with the parents.
What is teach the client about cortisol replacement therapy?
The nurse should plan to teach the child's parents about cortisol replacement therapy. Administration of glucocorticoids and mineralocorticoids is necessary because inadequate supplies or a sudden cessation of the medications can cause acute adrenal crisis.
A nurse is providing teaching to a client who has a new diagnosis of type 2 diabetes mellitus. The nurse should recognize that the client understands the teaching when he identifies which of the following as manifestations of hypoglycemia? (Select all that apply.)
1) Polydipsia, 2) Polyuria, 3) Blurred Vision, 4) Tachycardia, 4) Moist Clammy Skin
What Blurred Vision, Tachycardia, and Moist Clammy Skin?
A nurse in an emergency department is caring for a client who has diabetic ketoacidosis (DKA) and a blood glucose level of 925 mg/dL. The nurse should anticipate which of the following prescriptions from the provider?
1) Glucocorticoid medications, 2) Dextrose 5% in 0.45% sodium chloride, 3) Oral hypoglycemic medications, 4) 0.9% sodium chloride IV bolus
What is 0.9% sodium chloride IV bolus?
Rationale: The nurse should expect a prescription for an IV bolus of 0.9% sodium chloride to be administered at 15 to 20 mL/kg/hr for the first hour to restore volume and maintain perfusion to the vital organs.
A nurse is admitting a client who has sickle cell anemia. Which of the following manifestations should the nurse expect with this condition? Select All That Apply.
1) Pain, 2) Anxiety, 3) Sleeplessness, 4) Difficulty Speaking, 5) Depression
What is pain, anxiety, sleeplessness, and depression?
A nurse is assessing a client who has Graves' disease. The nurse should expect which of the following laboratory results?
1) Decreased thyroid-stimulating hormone (TSH) level, 2) Decreased triiodothyronine (T3) level, 3) Decreased thyroxine (T4) level, 4) Decreased thyroid-stimulating immunoglobulins (TSI) percentage
What is Decreased thyroid-stimulating hormone (TSH) level?
A nurse is planning care for a client who has thrombocytopenia. Which of the following interventions should the nurse include in the plan?
1) Apply pressure to needlestick sites for 10 min. 2) Assess core temperatures using a rectal thermometer. 3) Measure abdominal girth twice weekly. 4) Monitor for the presence of WBCs in the urine.
What is apply pressure to needlestick sites for 10 min?
A nurse is caring for a client who has a long history of diabetes mellitus and is being admitted to the emergency department confused, flushed, and with an acetone odor on the breath. Diabetic ketoacidosis is suspected. The nurse should anticipate using which of the following types of insulin to treat this client?
1) NPH insulin, 2) Insulin glargine, 3) Insulin determir, 4) Regular insulin
What is regular insulin?
A nurse is teaching a client who has type 1 diabetes mellitus about exercise. Which of the following instructions should the nurse include?
1) Perform vigorous exercise when blood glucose is less than 100 mg/dL., 2) Do not exercise if ketones are present in your urine, 3) 3) Avoid eating for 2 hr before exercise., 4) 4) Examine your feet weekly
What is Do not exercise if ketones are present in your urine?
What pain medications, Hydroxyurea, blood transfusion, 0.9% NaCl infusions?
A nurse is caring for a client who is 1 day postoperative following a subtotal thyroidectomy. The client reports a tingling sensation in the hands, the soles of the feet, and around the lips. For which of the following findings should the nurse assess the client?
1) Chvostek's sign, 2) Babinski's sign, 3) Brudzinski's sign, 4) Kernig's sign
What is Chvostek's sign?
Rationale:
Answer Rationale:
The nurse should suspect that the client has hypocalcemia, a possible complication following subtotal thyroidectomy. Manifestations of hypocalcemia include numbness and tingling in the hands, the soles of the feet, and around the lips, typically appearing between 24 and 48 hr after surgery. To elicit Chvostek's sign, the nurse should tap the client's face at a point just below and in front of the ear. A positive response would be twitching of the ipsilateral (same side only) facial muscles, suggesting neuromuscular excitability due to hypocalcemia.
A nurse is reviewing the laboratory findings for a client who has idiopathic thrombocytopenic purpura (ITP). Which of the following findings should the nurse expect to be decreased?
1) WBC, 2) RBC, 3) Granulocytes, 4) Platelets
What is platelets?
Answer Rationale:
The nurse should recognize that ITP results from the destruction of platelets by antibodies; therefore, the nurse should expect a platelet level below the expected reference range.