A nurse is educating a patient with diabetes mellitus about the chronic complications associated with the disease. What information should be included in the teaching?

Schedule and keep appointments for annual eye exams.

Ensure adequate fluid intake to prevent kidney damage.

Cardiac enzymes will be checked every 6 months.

Podiatry exams are necessary every 3 months.

Answer and Explanation

The Correct Answer is A

Choice A rationale

Diabetes mellitus can lead to several chronic complications, including retinopathy, which can cause blindness. Regular eye exams are crucial for early detection and treatment of diabetic retinopathy. Therefore, scheduling and keeping appointments for annual eye exams is an important part of managing diabetes.

Choice B rationale

While adequate fluid intake is generally important for overall health, it is not specifically effective in preventing kidney damage in patients with diabetes mellitus. Kidney damage in diabetes, also known as diabetic nephropathy, is caused by high blood sugar levels over time, not by dehydration.

Choice C rationale

Regular checks of cardiac enzymes are not a standard part of diabetes management. Cardiac enzymes are typically checked in the context of suspected heart disease or a heart attack, not as a routine measure in diabetes care.

Choice D rationale

While regular foot care is important in diabetes to prevent complications such as foot ulcers and infections, podiatry exams every 3 months are not typically necessary unless the patient has a history of foot problems or a high risk of foot complications.

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Correct Answer is C

Explanation

Choice A rationale

Placing the patient back on the heparin infusion and redrawing laboratory values would not be the appropriate next step. The INR of 1.9 is below the therapeutic range of 2.0 - 3.0 for most patients on warfarin. Therefore, the warfarin therapy is not yet fully effective, and there is no need to revert to heparin.

Choice B rationale

Asking the healthcare provider if the patient’s medication can be changed to rivaroxaban would not be the appropriate next step. Rivaroxaban is a different type of anticoagulant and would not necessarily be more effective in this situation.

Choice C rationale

Notifying the healthcare provider and asking if the dose of warfarin can be increased would be the appropriate next step. The INR of 1.9 is below the therapeutic range of 2.0 - 3.0 for most patients on warfarin. Therefore, an increase in the warfarin dose may be necessary to achieve therapeutic anticoagulation.

Choice D rationale

Preparing to administer a dose of Vitamin K subcutaneously would not be the appropriate next step. Vitamin K is used to reverse the effects of warfarin and would be counterproductive in this situation.

A. Obtain a full set of vital signs. B. Administer 1 mg glucagon subcutaneously. C. Administer 25 mL of 50% dextrose. D. Obtain a blood glucose reading.

Correct Answer is D

Explanation

Choice A rationale

While obtaining a full set of vital signs is an important part of assessing a patient’s condition, it should not be the initial action in this case. The symptoms described by the patient suggest hypoglycemia, which requires immediate confirmation and treatment.

Choice B rationale

Administering 1 mg glucagon subcutaneously is not the initial action. Glucagon is used to treat severe hypoglycemia when the patient is unable to take glucose orally. However, the patient’s blood glucose level should be checked first.

Choice C rationale

Administering 25 mL of 50% dextrose is not the initial action. This treatment is used for severe hypoglycemia, but the patient’s blood glucose level should be checked first to confirm hypoglycemia.

Choice D rationale

Obtaining a blood glucose reading is the correct initial action. The symptoms described by the patient suggest hypoglycemia. Checking the blood glucose level will confirm whether the patient is hypoglycemic and needs treatment.

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A nurse is educating a patient with diabetes mellitus about the chronic complications associated with the disease. What information should be included in the teaching?

Choice A rationale

Choice B rationale

Choice C rationale

Choice D rationale

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A patient has been receiving warfarin sodium 2.5 mg PO daily for four days and the International Normalized Ratio (INR) is 1.9. What should be the nurse’s next step?

Correct Answer is C

Explanation

Choice B rationale

Choice C rationale

Choice D rationale

A patient is recovering from an episode of diabetic ketoacidosis and reports feeling “anxious, shaky, and sweaty.”. What should be the nurse’s initial action?

Correct Answer is D

Explanation

Choice B rationale

Choice C rationale

Choice D rationale

A client is receiving heparin sodium 1000 units per hour via an infusion and warfarin sodium 2.5 mg PO for thrombophlebitis in the left leg. The nurse educates the client that heparin and warfarin are prescribed together because:

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The nurse teaches a diabetic patient how to perform foot care. Which action by the patient would indicate that they can correctly perform foot care?

The nurse is educating a client who has been newly prescribed acarbose in addition to repaglinide for the treatment of Type 2 diabetes. Which statement made by the client indicates that the teaching has been effective?

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