A Type 1 diabetic client’s blood glucose level is 50 mg/dL at 16:30. The client is alert; however, dinner will not be served until 17:15. What should be the nurse’s initial action?
Have the client drink 4 oz. of orange juice
Give the client 3 tbsp.
of sugar dissolved in 4 oz. of grape juice to drink
Monitor the client closely until dinner arrives
The Correct Answer is A
Step 1 is to understand that a blood glucose level of 50 mg/dL is considered hypoglycemic. Immediate treatment is necessary to raise the blood glucose level.
Step 2 is to follow the 15-15 rule for treating hypoglycemia, which recommends consuming 15 grams of carbohydrates and then checking blood glucose levels after 15 minutes. Four ounces of orange juice contains about 15 grams of carbohydrates and can quickly raise blood glucose levels.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
Consuming excessive amounts of antacids, such as TUMS, can lead to metabolic alkalosis. Antacids contain bicarbonate, which can neutralize stomach acid. However, excessive bicarbonate in the body can disrupt the acid-base balance, leading to metabolic alkalosis.
Choice B rationale
Respiratory acidosis is typically caused by conditions that result in hypoventilation, such as lung diseases or drug overdose, not by excessive antacid consumption.
Choice C rationale
Metabolic acidosis is typically caused by conditions that increase acid in the body or decrease bicarbonate, such as kidney disease or lactic acidosis, not by excessive antacid consumption.
Choice D rationale
Respiratory alkalosis is typically caused by conditions that result in hyperventilation, such as anxiety or fever, not by excessive antacid consumption.
Correct Answer is A
Explanation
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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