An adult client with type 2 diabetes mellitus (DM2) is to be admitted within the next hour to the medical unit from the emergency department. The client's laboratory findings indicate that

the serum glucose is 175 mg/dL (9.63 mmol/L) and the A1c is 9%.
When requesting a dinner tray for the client, which menu should the nurse select?

Reference Ranges:

Blood glucose [74 to 106 mg/dL (4.1 to 5.9 mmol/L)] HbA1C [Good diabetic control: less than 7%]

Vegetarian lasagna with cheese and spinach, tossed green salad with ranch dressing, and fresh fruit.

Lean hamburger with cheese, tomato, and lettuce on a whole-wheat bun, and angel food cake.

Fried chicken breast, mashed potatoes, green beans, sliced tomatoes, and fresh apple pie.

Grilled fish with whole-grain brown rice, steamed broccoli, and pear poached in red wine.

Answer and Explanation

The Correct Answer is D

A. Vegetarian lasagna with cheese and spinach, tossed green salad with ranch dressing, and fresh fruit. This meal option contains carbohydrates from the lasagna, salad dressing, and fruit, which can raise blood glucose levels.
B. Lean hamburger with cheese, tomato, and lettuce on a whole-wheat bun, and angel food cake.

This meal option contains carbohydrates from the bun and angel food cake, which can raise blood glucose levels.
C. Fried chicken breast, mashed potatoes, green beans, sliced tomatoes, and fresh apple pie. This meal option contains significant amounts of carbohydrates from mashed potatoes and apple pie, which can raise blood glucose levels.
D. Grilled fish with whole-grain brown rice, steamed broccoli, and pear poached in red wine.

This meal option is lower in carbohydrates and contains healthier choices for a client with diabetes, helping to control blood glucose levels more effectively.

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Free Nursing Study Resources

Correct Answer is []

Explanation

Actions to Take:

A. Educate on disease process and management: Rheumatoid arthritis (RA) is a chronic

autoimmune disorder characterized by inflammation of the synovial membrane, leading to joint pain, swelling, and stiffness. Educating the client about RA helps them understand the disease, its

progression, treatment options, and the importance of adherence to prescribed medications and lifestyle modifications. This empowers the client to actively participate in managing their condition and improve outcomes.

B. Turn every two hours to offload bony prominences to prevent pressure injuries: Rheumatoid arthritis predisposes individuals to joint deformities and immobility due to joint inflammation and pain. Immobility increases the risk of pressure injuries, especially over bony prominences. Turning the client every two hours helps redistribute pressure, reduces the risk of pressure ulcers, and maintains skin integrity.

Potential Condition:

D. Rheumatoid arthritis: The client's clinical presentation, including bilateral joint pain and stiffness, positive rheumatoid factor, positive antinuclear antibody test, elevated erythrocyte sedimentation rate (ESR), and soft tissue swelling with marginal erosions on hand X-rays, is consistent with rheumatoid arthritis (RA). RA is a chronic autoimmune disease characterized by inflammation of the synovial joints, leading to joint damage, pain, and functional impairment.

Parameters to Monitor:

C. Pain: Monitoring pain is essential in rheumatoid arthritis management to assess the effectiveness of pain management interventions and adjust treatment accordingly. Pain assessment tools, such as numerical rating scales or visual analog scales, help quantify pain intensity and guide pain management strategies.

D. Skin breakdown: Rheumatoid arthritis can limit mobility and predispose individuals to prolonged immobility, increasing the risk of pressure injuries. Monitoring for signs of skin breakdown, such as erythema, blanchable or non-blanchable skin changes, and skin integrity over bony prominences, helps prevent pressure ulcers and facilitates early intervention if skin breakdown occurs. Regularly turning the client, maintaining proper positioning, and providing adequate support surfaces are essential to prevent pressure injuries.

A. Neutralizes hydrochloric acid (HCI) in the stomach. B. Inhibits action of acetylcholine by blocking parasympathetic nerve endings. C. Destroys microorganisms causing stomach inflammation. D. Decreases the amount of HCI secretion by the parietal cells in the stomach.

Correct Answer is D

Explanation

A. Histamine 2-receptor antagonists do not directly neutralize hydrochloric acid (HCl) in the stomach. Instead, they reduce acid secretion by blocking the histamine 2 receptors on parietal cells, thereby decreasing the production of gastric acid.

B. This describes the mechanism of action of anticholinergic medications, not histamine 2- receptor antagonists.

C. Histamine 2-receptor antagonists do not have antimicrobial properties and are not used to destroy microorganisms causing stomach inflammation. They primarily target acid secretion.

D. This is the correct purpose of histamine 2-receptor antagonists. They work by blocking the action of histamine on parietal cells in the stomach, leading to a reduction in the secretion of hydrochloric acid. This helps in the management of peptic ulcer disease and other conditions related to excessive gastric acid secretion.

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Naxlex Comprehensive Predictor Exams

Exhibits Complete the diagram by dragging from the choices area to specify which condition the client is most likely experiencing, two actions the nurse should take to address that condition, and two parameters the nurse should monitor to assess the client's progress.

Correct Answer is []

Explanation

The nurse is preparing to administer a histamine 2-receptor antagonist to a client with peptic ulcer disease. What is the primary purpose of this drug classification?

Correct Answer is D

Explanation

A client with schizophrenia reports auditory hallucinations when admitted to the hospital. Which question is most important for the nurse to include in the assessment of this client?

The nurse is caring for a client with the sexually transmitted infection (STI) genital herpes. The client reports having sex with multiple partners. Which response should the nurse provide?

The nurse identifies an electrolyte imbalance, an elevated blood pressure, and a weight gain of 4.4 lbs (2 kg) in 24 hours for a client with hepatic failure. Which intervention should the nurse include in the plan of care?

The nurse plans to collect a 24-hour urine specimen for a creatinine clearance test. Which instruction should the nurse provide to the adult male client?