Exhibits

Nursing actions: Indicated/contraindicated/non-urgent

Teach the client how to count carbohydrates

Stop the insulin infusion

Decrease the frequency of blood glucose tests

Start the client on a regular diet

Decrease the insulin IV infusion to 0.05 units/kg/hr

Answer and Explanation

The Correct Answer is {"A":{"answers":"C"},"B":{"answers":"B"},"C":{"answers":"B"},"D":{"answers":"B"},"E":{"answers":"A"}}

A.   Teach the client how to count carbohydrates - Non-urgent. While essential for long- term management of diabetes, carbohydrate counting is not immediately critical in the acute management phase of HHS in the ICU. This teaching should be delayed until the patient is stabilized.
B.   Stop the insulin infusion - Contraindicated. Stopping insulin in a patient with HHS, which is characterized by severe hyperglycemia, would be harmful. Insulin therapy is critical to reduce blood glucose levels safely.

C.   Decrease the frequency of blood glucose tests - Contraindicated. Frequent monitoring is crucial in managing HHS, especially when insulin therapy is being administered, to prevent hypoglycemia and to monitor the effectiveness of treatment.
D.   Start the client on a regular diet - Contraindicated. Introducing a regular diet during the acute phase of HHS could exacerbate the hyperglycemia. Nutritional needs should be assessed and managed carefully, typically starting with IV fluids and gradually transitioning to enteral or oral feeding as the patient stabilizes.
E.   Decrease the insulin IV infusion to 0.05 units/kg/hr- Indicated. As blood sugar levels decrease, the insulin infusion rate may be cautiously reduced to prevent hypoglycemia.

Nursing Test Bank

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Correct Answer is A

Explanation

A. Ensuring comfort during the dying process is paramount in end-of-life care. Assessing and managing pain promptly supports quality of life and dignity in the client's final moments.
B. The nurse manager should be updated on the client's status. While communication with the nurse manager is important, it is not the immediate priority when a client is experiencing discomfort or pain.
C. The client's status should be conveyed to the chaplain. Involving spiritual care is important but secondary to addressing any immediate physical comfort needs of the client.
D. The impending signs of death should be documented. Documentation is important, but it is a secondary priority to the direct care and comfort needs of the client.

A. Tell the UAP to turn off the amiodarone. B. Evaluate rhythm of client's heat rate. C. Determine regularity of peripheral pulses. D. Restart the IV infusion in another site.

Correct Answer is B

Explanation

A. The UAP should not make medication decisions; only a nurse or healthcare provider should do this after assessment.
B. The nurse should evaluate the client’s heart rhythm to determine the effectiveness of the amiodarone and to assess for any arrhythmias or side effects of the medication.
C. Checking the regularity of peripheral pulses is important but secondary to assessing the heart rhythm directly.
D. Restarting the IV infusion might be necessary if there are issues with the IV site, but the primary concern is the client's cardiac status.

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Exhibits Nursing actions: Indicated/contraindicated/non-urgent

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client with a prescription for "do not resuscitate" (DNR) begins to manifest signs of impending death. After notifying the family of the client's status, which priority action should the nurse implement?

Correct Answer is A

Explanation

Correct Answer is B

Explanation

A client who underwent cardiac stent placement four days ago arrives to the emergency department reporting a sudden onset of chest pressure and shortness of breath. Which action should the nurse take next?

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Exhibits

Nursing actions: Indicated/contraindicated/non-urgent