A nurse is teaching a client who has type 1 diabetes mellitus about treating a hypoglycemic episode. Which of the following statements should the nurse include in the teaching?

"Drink 4 to 6 ounces of juice.”

"Consume two glucose tablets and check your blood glucose 1 hour later."

"Consume 1 teaspoon of corn syrup-based glucose gel."

"Eat two crackers with peanut butter.”

Answer and Explanation

The Correct Answer is A

A. "Drink 4 to 6 ounces of juice.": Drinking 4 to 6 ounces of juice, which contains carbohydrates, will quickly raise blood glucose levels. This amount is sufficient to correct mild hypoglycemia.
B. "Consume two glucose tablets and check your blood glucose 1 hour later.": After consuming glucose tablets, the client should check their blood glucose in about 15 minutes, not 1 hour. If blood glucose is still low, more glucose should be consumed sooner.
C. "Consume 1 teaspoon of corn syrup-based glucose gel.": One teaspoon of glucose gel is not enough to treat hypoglycemia. A typical recommendation would be 15-20 grams of fast-acting carbohydrates (e.g., glucose tablets or juice), which is more than 1 teaspoon of gel.
D. "Eat two crackers with peanut butter.": This combination is not ideal for treating hypoglycemia quickly. The protein in peanut butter will slow the absorption of glucose, which delays the correction of hypoglycemia. Fast-acting carbohydrates are preferred for rapid treatment.

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Correct Answer is B

Explanation

A. Serous drainage noted in the collection chamber: The type of drainage typically seen with a pneumothorax is not serous; it is usually minimal or absent. If there is significant drainage, it could indicate bleeding or another issue that should be monitored.

B. Tidaling in the water seal chamber with respirations: Tidaling, or the movement of the water level in the water seal chamber with respirations, is a normal finding. It indicates that the chest tube is correctly placed, and the lung is expanding and contracting.

C. Diminished breath sounds in the lung bases: Diminished breath sounds are expected in the area where the pneumothorax occurred, but it does not specifically indicate the placement of the chest tube.

D. Movement of the trachea toward the unaffected side: Tracheal deviation toward the unaffected side is a sign of tension pneumothorax, which is a medical emergency. It should not be expected following the placement of a chest tube for a pneumothorax, as the goal of the chest tube is to resolve the pneumothorax and prevent complications.

A. Apply mitten restraints to prevent the client from disconnecting their tube feeding. B. Apply soft heel protectors bilaterally while client is in bed. C. Apply a vest restraint daily at bedtime to prevent nighttime wandering. D. Apply an abduction pillow between the client's knees while they are in bed to prevent hip dislocation.

Correct Answer is C

Explanation

A. Apply mitten restraints to prevent the client from disconnecting their tube feeding: Mitten restraints are often used to prevent clients from pulling out tubes or disrupting medical devices. The nurse can apply these restraints as long as they follow the prescribed protocol.

B. Apply soft heel protectors bilaterally while client is in bed: Soft heel protectors are commonly used to prevent pressure ulcers or skin breakdown in immobile clients. This is a standard, non-controversial intervention and does not require verification.

C. Applying a vest restraint daily at bedtime to prevent nighttime wandering is considered a physical restraint used for convenience or punishment, which is a violation of client rights and safety. Restraints should only be used as a last resort when all less restrictive alternatives have failed and for the shortest duration possible.

D. Apply an abduction pillow between the client's knees while they are in bed to prevent hip dislocation: The use of an abduction pillow is common after hip replacement surgery or for patients at risk of hip dislocation. This is an appropriate intervention.

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A nurse is teaching a client who has type 1 diabetes mellitus about treating a hypoglycemic episode. Which of the following statements should the nurse include in the teaching?

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