A nurse is teaching a client who was recently diagnosed with type 1 diabetes mellitus. Which of the following statements by the client indicates an understanding of the teaching?

"I will drink half of a cup of fruit juice when I feel shaky and weak."

"I will soak my feet in water before applying lotion between my toes."

"I will skip a snack if I'm not hungry after lunch."

"I will only go without socks and shoes when I am in my home."

Answer and Explanation

The Correct Answer is A

Rationale:

A. "I will drink half of a cup of fruit juice when I feel shaky and weak.": Shakiness and weakness are early signs of low blood glucose, and consuming 15 grams of a fast-acting carbohydrate like ½ cup of fruit juice is an appropriate immediate response.

B. "I will soak my feet in water before applying lotion between my toes.": Diabetic clients should avoid soaking their feet due to the risk of skin maceration and infection. Lotion should not be applied between the toes, as this can promote fungal growth in a moist environment.

C. "I will skip a snack if I'm not hungry after lunch.": Skipping snacks can lead to hypoglycemia, especially if insulin has been administered. Even when not hungry, small carbohydrate intake may be necessary depending on the insulin regimen and activity level.

D. "I will only go without socks and shoes when I am in my home.": Diabetic clients should always wear protective footwear, even at home, to avoid undetected foot injuries that can lead to ulcers or infections due to impaired sensation and circulation.

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Correct Answer is B

Explanation

Rationale:

A. Cheyne-Stokes respirations: This irregular breathing pattern is common in clients nearing end of life due to neurologic decline. It is not a direct indicator of pain and does not necessarily require pain medication unless associated with distress.

B. Restlessness: Restlessness in a palliative care client often signals unrelieved pain, discomfort, or anxiety. It is a nonverbal cue frequently observed in clients unable to communicate pain and should prompt consideration of analgesia.

C. Mottled skin: Mottling is a sign of reduced perfusion and impending death. It reflects circulatory changes but does not directly indicate pain or warrant pain medication unless accompanied by other signs of distress.

D. Constricted pupils: Pupil constriction may result from certain medications (e.g., opioids) or brainstem pressure but is not a reliable sign of pain. It does not, by itself, indicate a need for analgesic intervention.

A. Instruct the client to have his testosterone checked in 1 week B. Wear clean gloves to apply the gel. C. Apply the gel to the client's genital region D. Advise the client to wait 1 hr before showering or swiming

Correct Answer is D

Explanation

Rationale:

A. Instruct the client to have his testosterone checked in 1 week: Testosterone levels are typically monitored after several weeks of therapy, not within just one week. Early testing may not accurately reflect the medication's effectiveness or stability in the bloodstream.

B. Wear clean gloves to apply the gel: Gloves must be worn, but they should be disposable and protective not simply clean gloves. This prevents accidental transdermal absorption of testosterone by the nurse, which can have hormonal effects, especially in females.

C. Apply the gel to the client's genital region: Testosterone gel should not be applied to the genital area due to the risk of irritation and unpredictable absorption. Recommended sites include the shoulders, upper arms, or abdomen where the skin is intact and dry.

D. Advise the client to wait 1 hr before showering or swimming: The client should be instructed to wait at least 1 hour to allow for full absorption of the gel. Showering or swimming too soon can reduce the effectiveness of the medication.

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A nurse is teaching a client who was recently diagnosed with type 1 diabetes mellitus. Which of the following statements by the client indicates an understanding of the teaching?

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Naxlex Comprehensive Predictor Exams

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