A nurse is assisting with the care of a client in the clinic.
Complete the following sentence by using the lists of options.
The client is at greatest risk for developing
The Correct Answer is {"dropdown-group-1":"B","dropdown-group-2":"B"}
The client reports dizziness, lightheadedness, and problems when skipping meals, which suggests concern for blood glucose instability and cardiovascular effects of prescribed medications. Beta-blockers such as metoprolol can mask the adrenergic warning signs of hypoglycemia, making low blood sugar more dangerous for diabetic clients. Recognizing medication interactions and adverse effects is essential for preventing complications and promoting safe chronic disease management.
Rationale for correct choices:
• Hypoglycemia: Clients with diabetes are at risk for hypoglycemia, especially when meals are skipped or appetite is poor. Even though metformin itself rarely causes hypoglycemia, missed meals combined with glucose-lowering therapy can increase risk. In addition, beta-blockers can prevent recognition of early warning signs such as tachycardia and tremors. This makes hypoglycemia the most significant potential complication requiring attention.
• Metoprolol: This is a beta-blocker that can mask common adrenergic symptoms of hypoglycemia such as palpitations, tremors, and tachycardia. As a result, the client may not recognize blood glucose drops until symptoms become severe, such as confusion or syncope. Since this client already reports skipping meals, the risk becomes more significant.
Rationale for incorrect choices:
• Bradycardia: Although metoprolol can cause bradycardia, the client’s current heart rate is 62/min, which is within normal range and not immediately concerning. The greater risk is unrecognized hypoglycemia because the client reports skipped meals and dizziness. Bradycardia is possible, but it is less urgent and less supported by the findings than hypoglycemia.
• Paresthesia: This is more commonly associated with diabetic neuropathy or significant electrolyte disturbances rather than the medications listed here. The potassium level is normal at 3.5 mEq/L, and potassium chloride is being given to maintain balance, not causing neurologic symptoms. Metformin may contribute to vitamin B12 deficiency over long-term use, but that is not the primary risk highlighted in this scenario.
• Metformin: This primarily lowers hepatic glucose production and generally does not cause hypoglycemia when used alone. It is safer in this regard compared to insulin or sulfonylureas. While skipped meals may still contribute to low glucose symptoms, metformin itself is not the major cause of masked or severe hypoglycemia.
• Potassium: Potassium chloride is prescribed to prevent or correct hypokalemia and does not directly cause hypoglycemia. The client’s potassium level is at the lower end of normal, making supplementation appropriate. While abnormal potassium levels can affect cardiac conduction and muscle function, they do not explain the client’s concern about skipped meals and blood sugar changes.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Accurate measurement of a tympanic temperature depends on correct alignment of the ear canal with the tympanic membrane to ensure proper infrared detection of body temperature. The procedure requires appropriate positioning of the ear to straighten the external auditory canal, allowing the probe to obtain a reliable reading from the tympanic membrane. Proper technique is especially important in clinical settings where temperature trends are used to monitor infection or inflammatory processes.
Rationale:
A. Positioning the client facing the nurse is not required for tympanic temperature measurement. While proper positioning can improve ease of access, it does not influence the accuracy of the reading. The key determinant of correct technique is proper alignment of the ear canal rather than client orientation.
B. Pointing the probe posteriorly is incorrect because the probe must be directed toward the tympanic membrane, not away from it. Misalignment of the probe can result in inaccurate temperature readings due to improper infrared detection. Correct technique requires gentle insertion following the natural curvature of the ear canal.
C. Pulling the pinna up and back is the correct technique for an adult when measuring tympanic temperature. This action straightens the external auditory canal, allowing the probe to align directly with the tympanic membrane for accurate measurement. Proper positioning ensures reliable detection of infrared heat emitted from the eardrum.
D. Inserting the probe with a straight forward motion is incorrect because the ear canal is not a straight structure. A direct forward insertion can cause discomfort, inaccurate positioning, and unreliable readings. The probe should follow the natural angle of the canal after proper manipulation of the pinna.
Correct Answer is A
Explanation
Sleep disturbances in preschool-aged children are commonly related to inconsistent routines, overstimulation, and poor sleep hygiene. At this developmental stage, establishing predictable bedtime habits is essential for promoting healthy sleep patterns and emotional regulation. Exposure to stimulating activities such as screens can delay sleep onset by increasing arousal and suppressing melatonin secretion. Nurses should educate caregivers on structured routines that support restful sleep in children during early development.
Rationale:
A. Limiting media use before bedtime is appropriate because screen exposure increases cognitive stimulation and delays sleep onset. Blue light from devices can suppress melatonin production, disrupting the child’s natural sleep-wake cycle. Reducing screen time before bed promotes relaxation and improves sleep quality in preschool children.
B. Allowing the child to stay up later is not recommended because it disrupts circadian rhythm and can worsen sleep disturbances. Preschool children require consistent sleep schedules to support growth, behavior regulation, and cognitive development. Delayed bedtime often leads to overtiredness and more difficulty falling asleep.
C. Altering bedtime rituals daily is inappropriate because inconsistent routines increase anxiety and reduce the child’s ability to anticipate sleep. Predictable bedtime routines provide security and signal the transition from wakefulness to sleep. Frequent changes can exacerbate sleep resistance and disturbances.
D. Avoiding a night light is not necessary and may actually increase fear or nighttime anxiety in some preschool children. A low-intensity night light can provide reassurance and help reduce sleep disruptions related to fear of darkness. The key is moderation rather than complete elimination.
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