A Type 1 diabetic client with a morning (fasting) glucose of 260 mg/dL has been diagnosed with the Somogyi effect from insulin administration.
What intervention should the nurse anticipate including in the plan of care?

Increase the nighttime insulin glargine dose.

Ensure a snack is consumed at bedtime.

Check the morning cortisol level.

Check the glucose level at 2 a.m. and 8 a.m.

Answer and Explanation

The Correct Answer is B

Choice A rationale

Increasing the nighttime insulin glargine dose may exacerbate the Somogyi effect, a phenomenon where the blood sugar level drops too low overnight, causing a rebound high blood sugar level in the morning.

Choice B rationale

Consuming a snack at bedtime can help prevent the blood sugar level from dropping too low overnight, thus preventing the Somogyi effect.

Choice C rationale

Checking the morning cortisol level is not directly related to managing the Somogyi effect.

Choice D rationale

Checking the glucose level at 2 a.m. and 8 a.m. can help identify the Somogyi effect, but it does not prevent it.

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Correct Answer is D

Explanation

Choice A rationale

Testing the stool for occult blood is not typically necessary for a client taking an antibiotic that causes diarrhea. While antibiotics can cause changes in the gastrointestinal tract, they do not typically cause gastrointestinal bleeding.

Choice B rationale

Increasing roughage in the diet can help bulk up the stool and may help alleviate some cases of diarrhea. However, it’s not the primary recommendation for a client taking an antibiotic that causes diarrhea.

Choice C rationale

Requesting the physician for a different antibiotic if diarrhea persists can be an appropriate action. However, this is typically recommended after other strategies, such as adding probiotics to the diet, have been tried.

Choice D rationale

Adding yogurt to the diet is often recommended for clients taking an antibiotic that causes diarrhea. Yogurt contains probiotics, which can help restore the balance of good bacteria in the gut and alleviate diarrhea.

A. The client will verbalize an understanding of appropriate foot care measures by discharge. B. The client will verbalize the importance of taking anti-platelet medications by discharge. C. The client will discuss exercises that promote healing of wounds prior to discharge. D. The client will recognize the need for an amputation in the near future.

Correct Answer is A

Explanation

Choice A rationale

The client diagnosed with peripheral arterial disease has impaired tissue integrity related to ischemic tissue of the legs and feet. This condition is often caused by factors such as physical trauma, thermal factors, chemical injury, infection, nutritional imbalances, fluid imbalances, and altered circulation. The most appropriate outcome to include in the care plan would be for the client to verbalize an understanding of appropriate foot care measures by discharge. This is because maintaining skin integrity and providing effective wound care are crucial aspects of managing this condition. By understanding and implementing appropriate foot care measures, the client can help prevent further tissue damage, promote healing, and improve their overall quality of life.

Choice B rationale

While taking anti-platelet medications can be an important part of managing peripheral arterial disease, it may not directly address the nursing problem of impaired tissue integrity. Anti-platelet medications can help prevent blood clots and improve blood flow, but they do not directly promote wound healing or tissue regeneration.

Choice C rationale

Discussing exercises that promote healing of wounds can be beneficial for the client. However, it’s important to note that exercises should be appropriate for the client’s condition and overall health status. Overexertion or inappropriate exercises could potentially exacerbate the condition and further impair tissue integrity.

Choice D rationale

Recognizing the need for an amputation in the near future can be a realistic outcome for some clients with severe peripheral arterial disease. However, this is typically considered a last resort when all other treatment options have failed. It’s also a drastic measure that can significantly impact the client’s quality of life.

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A Type 1 diabetic client with a morning (fasting) glucose of 260 mg/dL has been diagnosed with the Somogyi effect from insulin administration. What intervention should the nurse anticipate including in the plan of care?

Choice A rationale

Choice B rationale

Choice C rationale

Choice D rationale

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is aware that a client taking an antibiotic that causes diarrhea should be taught about:

Correct Answer is D

Explanation

Choice A rationale

Choice B rationale

Choice C rationale

Choice D rationale

A client diagnosed with peripheral arterial disease has the nursing problem of Impaired Tissue Integrity related to ischemic tissue of the legs and feet. What is an expected outcome to include in the care plan?

Correct Answer is A

Explanation

Choice A rationale

Choice B rationale

Choice C rationale

Choice D rationale

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A Type 1 diabetic client with a morning (fasting) glucose of 260 mg/dL has been diagnosed with the Somogyi effect from insulin administration.
What intervention should the nurse anticipate including in the plan of care?