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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Correct Answer is C

Explanation

A. Encourage mobilization to prevent pulmonary embolism.
While mobilization can be important in preventing further DVT development, initial bed rest is often recommended to avoid dislodging the clot. Mobilization should be carefully managed based on the provider's recommendations.

B. Measure each calf's girth to evaluate edema in the affected leg.
Measuring calf girth is useful for monitoring the extent of the DVT, but it is not the most critical intervention compared to monitoring for complications of heparin therapy.

C. Observe for bleeding side effects related to heparin therapy.
This is the correct intervention. Heparin is an anticoagulant, and monitoring for signs of bleeding (such as in the gums, urine, stool, and bruising) is crucial to prevent serious complications.

D. Assess blood pressure and heart rate at least every 4 hours.
While important, frequent monitoring of vital signs is secondary to the need to vigilantly observe for bleeding, which is a direct and significant risk of heparin therapy.

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

A client with deep vein thrombosis (DVT) in the left leg is on a heparin protocol. Which intervention is most important for the nurse to include in this client's plan of care?

Correct Answer is C

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

The parents of a 6-year-old child recently diagnosed with Duchenne muscular dystrophy tell the nurse that their child wants to continue attending swimming classes. How should the nurse respond?

The nurse is providing teaching to a client admitted with a blood glucose level of 580 mg/dL about preventing complications related to diabetes mellitus. Which information reported by the client indicates understanding?

A client experiencing withdrawal from the benzodiazepine alprazolam is demonstrating severe agitation and tremors. Which is the best initial nursing action?

An adolescent who is brought to the emergency department (ED) with a fever and persistent lower right quadrant abdominal pain is anxious, fearful, and hyperventilating. The nurse anticipates the client developing which acid-base imbalance?

Exhibits To start the client on oxygen as ordered, what item(s) should the nurse collect from the supply room? Select all that apply.

Exhibits What laboratory specimens would the nurse expect for the provider to order? Select all that apply.

The nurse identifies the presence of clear fluid on the surgical dressing of a client who just returned to the unit following lumbar spinal surgery. Which action should the nurse implement immediately?