A nurse is caring for a client who has hypoglycemia.
The nurse should monitor the client for which of the following adverse effects of hypoglycemia?
Fever.
Shakiness.
Increased urination.
Thirst.
The Correct Answer is B
Choice A rationale:
Fever. Fever is not an adverse effect of hypoglycemia. Fever is usually associated with an elevated body temperature, often due to infection or other inflammatory conditions, and is not directly related to low blood sugar levels.
Choice B rationale:
Shakiness. Shakiness is a common symptom of hypoglycemia. When blood sugar levels drop too low, the body responds with symptoms like trembling or shakiness, which is caused by the release of stress hormones like epinephrine. These symptoms are the body's way of signaling the need for immediate glucose intake to raise blood sugar levels.
Choice C rationale:
Increased urination. Increased urination is not a typical symptom of hypoglycemia. In fact, frequent urination may be associated with hyperglycemia (high blood sugar levels) in conditions like diabetes mellitus.
Choice D rationale:
Thirst. Thirst is not a direct symptom of hypoglycemia. Thirst is more commonly associated with hyperglycemia, where high blood sugar levels lead to increased urine output, causing dehydration and subsequent thirst. In hypoglycemia, the focus is on correcting the low blood sugar levels rather than managing thirst.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale:
While music therapy can be a helpful adjunct for pain management, it is not a replacement for all pain medications. Pain management should be individualized, and the statement that music therapy alone will eliminate the need for all medication is not accurate.
Choice B rationale:
Discontinuing music therapy when the patient is no longer responsive may not be the best approach. Music therapy can still provide comfort and support even if the patient is not responsive in the traditional sense. It should be continued if it benefits the patient.
Choice C rationale:
Playing music is not intended to increase alertness but rather to provide comfort and relaxation. This statement reflects a misunderstanding of the purpose of music therapy in pain management.
Choice D rationale:
This statement correctly indicates an understanding of the purpose of music therapy. Music can distract the patient from pain and provide a sense of comfort and relaxation without completely eliminating awareness of pain.
Correct Answer is A
Explanation
Choice A rationale:
The charge nurse should identify the social worker as appropriate to share client information with when it involves an involuntarily committed school-age client. This choice is correct because sharing information with a social worker who is actively involved in the client's care and has a legitimate need to know is in line with ethical and legal confidentiality requirements. Confidentiality should be maintained to protect the client's privacy, but sharing information with a healthcare team member who needs it to provide appropriate care is acceptable.
Choice B rationale:
Sharing a client's medical information with the client's employer due to concerns about substance use is not appropriate without the client's explicit consent. It is important to respect the client's confidentiality unless there is a legal obligation or a safety concern. In this case, obtaining the client's permission to share such information is crucial.
Choice C rationale:
Sharing a client's medical information with their partner after the client reports intimate partner abuse should be done with caution. While there may be instances where sharing is necessary to ensure the client's safety, it should ideally be done with the client's consent and while involving appropriate authorities. In some jurisdictions, there may be mandatory reporting requirements for domestic violence, but the client's consent should still be sought when possible.
Choice D rationale:
Sharing a client's medical information with a nurse from another unit after the client commits suicide is not appropriate without a legitimate reason, such as continuity of care. In such cases, information sharing should be limited to what is necessary for the provision of care and should be in accordance with facility policies and privacy laws. The primary consideration should be maintaining confidentiality while ensuring the safety and well-being of other patients and healthcare staff.
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