For a client with diabetes mellitus, which new lab finding is the greatest concern?

Potassium 5.0 mEq/L.

Creatinine 4.4 mg/dL.

Hemoglobin 10.7 g/dL.

Blood Urea Nitrogen (BUN) 22 mg/dL.

Answer and Explanation

The Correct Answer is D

Choice A Reason
A potassium level of 5.0 mEq/L is at the upper limit of the normal range, which is typically between 3.5 and 5.0 mEq/L. While this level should be monitored, especially in the context of diabetes where the patient may be at risk for hyperkalemia due to potential kidney issues, it is not immediately alarming¹.

Choice B Reason
A creatinine level of 4.4 mg/dL is significantly higher than the normal range of 0.6 to 1.2 mg/dL for males and 0.5 to 1.1 mg/dL for females. This indicates severe renal impairment or kidney failure, which is a serious complication of diabetes mellitus. Immediate intervention is required to address this critical issue¹.

Choice C Reason
A hemoglobin level of 10.7 g/dL is slightly below the normal range for adults, which is generally 13.8 to 17.2 g/dL for males and 12.1 to 15.1 g/dL for females. This could indicate mild anemia, which can be a complication of diabetes but is not as immediately concerning as a high creatinine level¹.

Choice D Reason
A Blood Urea Nitrogen (BUN) level of 22 mg/dL is within the normal range, which is typically between 7 and 20 mg/dL. This level does not indicate immediate concern and is not as critical as the elevated creatinine level¹.

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Correct Answer is A

Explanation

Choice a reason:
Bleeding at the arterial puncture site is a primary concern post-cardiac angiogram, as it can lead to significant blood loss and hematoma formation. The nurse must frequently monitor the site for any signs of bleeding or hematoma, apply pressure if necessary, and report any abnormalities to the physician immediately.

Choice b reason:
Cardiac dysrhythmias may occur due to irritation of the heart muscle by the catheter during insertion. Monitoring the client's heart rhythm is essential to detect any new onset of arrhythmias, which could indicate complications from the procedure.

Choice c reason:
Electrolyte imbalances can result from the contrast dye used during a cardiac angiogram. The dye can affect kidney function, leading to changes in electrolyte levels. Monitoring electrolyte levels is important to prevent complications such as arrhythmias or fluid imbalances.

Choice d reason:
While discomfort at the catheter insertion site is expected, it is typically mild. However, the nurse should assess for discomfort as it may indicate other issues such as infection, bleeding, or a reaction to the procedure.

A. Review the diet and exercise guidelines with the client. B. Ask the client whether there have been any changes in diet or exercise patterns. C. Recommend reducing calorie intake even more. D. Instruct the client to record weights weekly.

Correct Answer is B

Explanation

Choice A reason:
Reviewing the diet and exercise guidelines with the client is an important step, but it may not address the immediate issue of the weight loss plateau. It's essential to first understand if the client has adhered to the guidelines before reviewing them.

Choice B reason:
Asking the client about any changes in diet or exercise patterns is the first step in identifying potential causes for the weight loss plateau. Changes in lifestyle, stress levels, eating habits, or physical activity can all contribute to a halt in weight loss. Understanding these factors can help the nurse tailor further advice and support.

Choice C reason:
Recommending a further reduction in calorie intake might not be the best initial approach. It's important to ensure that the client is not already consuming too few calories, which can slow metabolism and hinder weight loss. Moreover, drastic calorie reduction can be unsustainable and lead to nutritional deficiencies.

Choice D reason:
Instructing the client to record weights weekly is a useful tool for monitoring progress, but it does not address the current issue of the weight loss plateau. It's a supportive action that should follow after understanding and addressing the reasons behind the plateau.

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For a client with diabetes mellitus, which new lab finding is the greatest concern?

Nursing Test Bank

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Explanation

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Correct Answer is B

Explanation

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