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?

4 oz diet soda

1 tsp sugar

4 oz skim milk

Graham crackers

Answer and Explanation

The Correct Answer is D

A. 4 oz diet soda: Diet soda contains artificial sweeteners, not real sugar, and therefore will not effectively raise blood glucose levels. It's not suitable for treating hypoglycemia.

B. 1 tsp sugar: While 1 tsp of sugar can provide some glucose, the amount is insufficient to treat hypoglycemia effectively. The American Diabetes Association recommends 15 grams of fast-acting carbohydrates, which is equivalent to about 4 teaspoons of sugar, not 1.

C. 4 oz skim milk: Skim milk contains both carbohydrates (approximately 12 grams of carbohydrates per 8 oz, so 4 oz would provide around 6 grams) and protein. While it can help raise blood glucose, it may not provide the recommended 15 grams of fast-acting carbohydrates to treat hypoglycemia quickly enough.

D. Graham crackers: Foods with a high glycemic index (GI), such as graham crackers, can cause blood sugar levels to rise relatively quickly. Graham crackers, being high in refined carbohydrates, can indeed result in a rapid increase in blood glucose levels compared to low-GI foods.

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Correct Answer is B

Explanation

A. Notify the provider of a weight gain of 0.5 kg (1 lb) in a week: A weight gain of 0.5 kg (1 lb) in a week can indicate fluid retention and worsening heart failure. Clients should be instructed to report such changes promptly to their healthcare provider to adjust treatment and prevent complications.

B. Exercise at least three times per week: Regular exercise is important for maintaining overall health and improving heart function. However, it is generally recommended to consult a healthcare provider to tailor an exercise regimen suitable for the client's condition.

C. Take diuretics early in the morning and before bedtime: Diuretics should typically be taken in the morning to avoid nocturia (frequent nighttime urination) and disruption of sleep. Taking them before bedtime is not advised due to the increased risk of sleep disturbance.

D. Take naproxen for generalized discomfort.: NSAIDs like naproxen are generally not recommended for clients with heart failure because they can cause sodium and fluid retention, potentially worsening heart failure symptoms.

A. "These tests help determine the degree of damage to the heart tissues." B. "These tests will enable the provider to determine the heart structure and mobility of the heart valves." C. "Cardiac enzymes assist in diagnosing the presence of pulmonary congestion." D. "Cardiac enzymes will identify the location of the MI."

Correct Answer is A

Explanation

A. "These tests help determine the degree of damage to the heart tissues.": Cardiac enzymes, such as troponins and creatine kinase-MB (CK-MB), are released into the blood when heart muscle is damaged. Elevated levels indicate the presence and extent of myocardial injury, helping to confirm the diagnosis of an MI.

B. "These tests will enable the provider to determine the heart structure and mobility of the heart valves.": This is incorrect; cardiac enzymes do not provide information about heart structure or valve function. An echocardiogram or other imaging studies are used for structural assessment.

C. "Cardiac enzymes assist in diagnosing the presence of pulmonary congestion.": Pulmonary congestion is not directly diagnosed with cardiac enzymes. It is typically identified through clinical assessment and imaging like chest X-rays.

D. "Cardiac enzymes will identify the location of the MI.": While cardiac enzymes confirm the presence of myocardial damage, they do not specify the exact location. The location is identified using ECG and imaging techniques.

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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?

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