A client with type 1 diabetes mellitus calls the home care nurse and reports taking a morning dose of 70/30 insulin before realizing they have a stomach virus and are now unable to eat breakfast due to nausea. Which initial instruction should the nurse provide the client?

Drink regular colas frequently throughout the day until the nausea subsides.

Do not inject any additional insulin until solid food can be tolerated.

Go to the emergency room as soon as possible for glucose administration.

Continue to monitor blood glucose levels and drink fluids as tolerated.

Answer and Explanation

The Correct Answer is D

Choice A reason: Drinking regular colas can lead to fluctuations in blood glucose levels and is not an appropriate recommendation for managing nausea in a client with diabetes.

Choice B reason: Not injecting additional insulin until solid food can be tolerated is not advisable, as it may lead to hyperglycaemia or diabetic ketoacidosis. Insulin needs to be managed carefully even if the client is not eating.

Choice C reason: Going to the emergency room immediately may not be necessary if the client can manage their blood glucose levels at home with proper guidance.

Choice D reason: Monitoring blood glucose levels and drinking fluids as tolerated is the best initial advice. This helps prevent dehydration and maintain glucose control while dealing with the nausea. The client should also follow sick day management guidelines for diabetes and stay in touch with their healthcare provider.

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Correct Answer is D

Explanation

Choice A reason: While high serum insulin levels can be indicative of insulin resistance and metabolic syndrome, they are not as directly related to cardiac risk as large waist circumference.

Choice B reason: Hyperpigmentation on neck skin folds, also known as acanthosis nigricans, can indicate insulin resistance and metabolic syndrome but is not as strong a predictor of cardiac disease as central obesity.

Choice C reason: Poor muscle tone is not a direct indicator of cardiac disease risk. It can be associated with overall health and fitness but is not as specific a risk factor for cardiac disease.

Choice D reason: Large waist circumference with central fat, also known as abdominal obesity, is a well-known risk factor for cardiovascular disease. Central fat is associated with increased risk of heart disease, hypertension, and diabetes, making it a significant indicator to monitor.

A. Client denies urinary frequency, urgency, or dysuria. B. Stone fragments are collected when straining the client's urine. C. Urine is pale pink with no observable blood clots. D. Serum creatinine and blood urea nitrogen (BUN) levels are within normal limits.

Correct Answer is B

Explanation

Choice A reason: Denial of urinary frequency, urgency, or dysuria is a good sign of symptom relief but does not directly confirm the success of the lithotripsy in terms of stone removal.

Choice B reason: The presence of stone fragments in the urine after lithotripsy indicates that the procedure successfully broke up the kidney stones, allowing them to be excreted. This is a direct and specific measure of the procedure's effectiveness.

Choice C reason: Pale pink urine with no observable blood clots is a positive sign and suggests that there is no significant bleeding, but it does not directly confirm the removal of the kidney stones.

Choice D reason: Normal serum creatinine and blood urea nitrogen (BUN) levels indicate good kidney function but do not specifically reflect the success of the lithotripsy in breaking up and removing the stones.

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A client with type 1 diabetes mellitus calls the home care nurse and reports taking a morning dose of 70/30 insulin before realizing they have a stomach virus and are now unable to eat breakfast due to nausea. Which initial instruction should the nurse provide the client?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse calculates the body mass index (BMI) for an adult client who is obese. Which additional assessment finding places the client at high risk for cardiac disease?

Correct Answer is D

Explanation

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Correct Answer is B

Explanation

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