A diabetes nurse educator is discussing "sick day rules" with a client newly diagnosed with diabetes mellitus type 1. Which statement by the client indicates a need for further teaching?

"I will consult with my healthcare provider before taking over-the-counter medications."

"I will not take my insulin on the days when I am sick, but I will certainly check my blood sugar every 2 hours."

"I will call the doctor if my illness lasts longer than 2 days."

"I will call the doctor if my blood sugar is over 250 mg/dL or if I have protein in my urine."

Answer and Explanation

The Correct Answer is B

A. Consulting with a healthcare provider before taking over-the-counter medications is appropriate, as some medications can affect blood glucose levels or interact with diabetes medications.
B. It is crucial for clients with diabetes to continue taking insulin during illness, even if they are unable to eat. Insulin needs may increase due to stress or infection, and not taking insulin could lead to hyperglycemia or diabetic ketoacidosis. Checking blood sugar every 2 hours is correct, but insulin should not be omitted.
C. Calling the doctor if the illness lasts longer than 2 days is a good practice, as prolonged illness can affect diabetes management and may require medical intervention.
D. Calling the doctor if blood sugar is over 250 mg/dL or if there is protein in the urine is appropriate, as these conditions can indicate complications that need medical attention.

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Correct Answer is A

Explanation

A. Current anticoagulant use is crucial to assess before administering t-PA because combining t-PA with anticoagulants can significantly increase the risk of bleeding complications. It is essential to ensure that the client is not on medications that could interact adversely with t-PA.
B. While blood pressure is important to monitor, it is secondary to assessing anticoagulant use since high blood pressure alone does not contraindicate t-PA administration.
C. A complete neurologic assessment is important for determining the extent of the stroke but is not the immediate priority before administering t-PA.
D. While treatment for peptic ulcer disease is relevant, it is not directly related to the immediate risk factors for t-PA administration compared to anticoagulant use.

A. Increase fluid intake. B. Decrease protein intake. C. Decrease carbohydrate intake. D. Limit intake of potassium-rich foods.

Correct Answer is C

Explanation

A. Increasing fluid intake is not recommended, as clients with Cushing disease often have fluid retention.
B. Decreasing protein intake is not recommended because muscle wasting is a concern in Cushing disease, and adequate protein is necessary to maintain muscle mass.
C. Decreasing carbohydrate intake is recommended because Cushing disease can cause hyperglycemia, and reducing carbohydrates can help manage blood glucose levels.
D. Limiting potassium-rich foods is not advisable as Cushing disease can lead to hypokalemia, and clients may need to increase their potassium intake.

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A diabetes nurse educator is discussing "sick day rules" with a client newly diagnosed with diabetes mellitus type 1. Which statement by the client indicates a need for further teaching?

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Naxlex Comprehensive Predictor Exams

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Correct Answer is A

Explanation

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Correct Answer is C

Explanation

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