The client is a 58-year-old male who wants to be screened for diabetes mellitus. The client has a sister who has type 2 diabetes. He has a history of depression, which is treated with paroxetine 10 mg orally every day. The client also states that he occasionally takes cannabis in edible form. He denies smoking or drinking. He works In a chemical factory where he is occasionally exposed to fumes. The client's BMI is 28.

Which of the following indicates an understanding? (Select all that apply)

If my fasting blood sugar is less than 100 next time, I can go back to my usual eating habits.

Making these changes will also help me avoid other chronic health conditions.

I can never eat sugar again.

If I make the changes we talked about, I will not get type 2 diabetes.

If I have symptoms like increased thirst and urination, I should come in and get my blood sugar checked.

Answer and Explanation

Correct Answer : B,E

Correct:

B- Making these changes will also help me avoid other chronic health conditions. This statement indicates an understanding because the client recognizes that the lifestyle changes discussed will not only help prevent or manage diabetes but also have a positive impact on other chronic health conditions such as cardiovascular disease and obesity.

E- If I have symptoms like increased thirst and urination, I should come in and get my blood sugar checked. This statement indicates an understanding because the client acknowledges the importance of monitoring their blood sugar levels if they experience symptoms commonly associated with diabetes, such as increased thirst and urination.

Incorrect choices:

A- If my fasting blood sugar is less than 100 next time, I can go back to my usual eating habits. This statement indicates a misunderstanding. It suggests that as long as the client's fasting blood sugar is below 100, they can resume their previous eating habits, which is not accurate. It's important to emphasize that long-term lifestyle changes are necessary, regardless of individual blood sugar readings.

C- I can never eat sugar again. This statement indicates a misunderstanding. While it's important to minimize the consumption of sugary foods and beverages, it's not necessary to completely eliminate all sugar from the diet. Moderation and mindful consumption are key.

D- If I make the changes we talked about, I will not get type 2 diabetes. This statement indicates a misunderstanding. While making positive lifestyle changes can significantly reduce the risk of developing type 2 diabetes, it does not guarantee complete prevention. Genetic and other factors can still influence an individual's susceptibility to the condition.

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Correct Answer is C

Explanation

The client finding that necessitates immediate attention by the practical nurse (PN) is a client who is having bright red drainage from the rectum following a colonoscopy with polyp removal. Bright red rectal bleeding can indicate active bleeding and immediate intervention is required to assess the severity of the bleeding, control the bleeding if possible, and prevent further complications.
A. The older client with a blood pressure of 100/70 after receiving meperidine for pain may require further assessment, but it does not indicate an immediate life-threatening condition.
B. Pink urine draining from the indwelling urinary catheter following a transurethral prostatectomy may be expected due to the surgical procedure, but it should still be monitored.
D. Brown-green bile draining from a T-tube after cholecystectomy for cholelithiasis is also an expected finding.

A. Discourage group activities. B. Engage in regular contact. C. Touch the client when speaking. D. Establish a no-harm contract.

Correct Answer is B

Explanation

the practical nurse (PN) should engage in regular contact with the client who demonstrates an inability to communicate effectively. Regular contact helps establish a therapeutic relationship and provides opportunities for observation and assessment of the client's needs and behavior. It also helps the PN to build trust with the client over time.
The other options listed are not appropriate methods for interacting with a client with psychosis who has difficulty communicating effectively:
A. Discouraging group activities: Group activities can be beneficial for individuals with psychosis as they provide opportunities for social interaction, skill-building, and support. It is important to encourage participation in appropriate group activities that are tailored to the client's needs and abilities.
C. Touching the client when speaking: Touching the client without their consent may be perceived as invasive or threatening, especially for individuals with psychosis who may already have difficulties with sensory processing or boundaries. It is important to respect the client's personal space and communicate through verbal means, maintaining a respectful and
non-intrusive approach.
D. Establishing a no-harm contract: No-harm contracts are typically used in the context of suicidal or self-harming behaviors to promote safety and identify support systems. While safety is important, it is not directly related to the communication difficulties associated with psychosis. Instead, the focus should be on developing a therapeutic relationship and finding effective means of communication with the client.

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Naxlex Comprehensive Predictor Exams

After the change-of-shift report, the practical nurse (PN) makes rounds on a postoperative unit. Which client finding necessitates the Immediate attention of the PN?

Correct Answer is C

Explanation

The practical nurse (PN) is caring for a client with psychosis who demonstrates an inability to communicate effectively. Which method should the PN use to interact with the client?

Correct Answer is B

Explanation

Two weeks after cast application, a client with a fractured right arm returns to the clinic for evaluation. The client seems upset and tells the practical nurse (PN) that the healthcare provider said a callus has formed on the bone. Which action should the PN take?

The practical nurse (PN) is assessing an older client with left-sided heart failure (HF). What intervention is most important for the PN to implement?

The practical nurse (PN) is caring for a child who was admitted after experiencing a generalized tonic-clonic seizure. When witnessing the child begin the seizure, what should the PN implement immediately? (Select all that apply.)

The practical nurse (PN) applies and then releases pressure to a client's fingernail as seen in the photo. Normal nail color returns in 2 seconds. Which action should the PN take?

In preparing to discontinue a client's saline lock, the practical nurse (PN) notes that the client is receiving an antiplatelet medication. Which action should the PN implement?

The practical nurse (PN) is auscultating a client's heart sounds. Which abnormal heart sound should the PN report to the charge nurse? (Please listen to the audio file to select the option that applies.)