The client’s blood sugar this morning is 50 mg/dL. The client states they are cold, sweating, and clammy. Which nursing intervention is most appropriate?

The blood sugar is normal, the client needs to drink water

Give the client fruit juice with additional sugar

Give 5 units of insulin

Call the healthcare provider immediately

Answer and Explanation

The Correct Answer is B

Choice A reason: A blood sugar of 50 mg/dL indicates hypoglycemia, not normal glucose levels (70-110 mg/dL). Symptoms like sweating and clamminess confirm this. Drinking water does not address hypoglycemia, as it lacks glucose to raise blood sugar, making this intervention inappropriate and potentially harmful.

Choice B reason: Hypoglycemia (50 mg/dL) with symptoms like sweating requires rapid glucose correction. Fruit juice with added sugar provides fast-acting carbohydrates (15-20g), raising blood sugar within minutes by stimulating glycogenolysis and glucose absorption. This is the most appropriate intervention to reverse hypoglycemia safely and effectively.

Choice C reason: Administering insulin during hypoglycemia (50 mg/dL) would further lower blood sugar, worsening symptoms and risking seizures or coma. Insulin drives glucose into cells, exacerbating the glucose deficit. This intervention is contraindicated and dangerous in the context of low blood sugar and neuroglycopenic symptoms.

Choice D reason: While consulting a healthcare provider may be needed for recurrent hypoglycemia, the immediate priority is correcting low blood sugar (50 mg/dL) with fast-acting carbohydrates. Delaying treatment by calling first risks prolonged hypoglycemia, potentially causing neurological damage, making this less appropriate than direct intervention.

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Correct Answer is A

Explanation

Choice A reason: Cognitive enhancers like donepezil or memantine are prescribed based on Alzheimer’s disease stage. Cholinesterase inhibitors are effective in mild-to-moderate stages, enhancing acetylcholine levels to improve cognition. Memantine, an NMDA receptor antagonist, is used in moderate-to-severe stages to regulate glutamate activity, slowing cognitive decline. This statement is accurate, as treatment is tailored to symptom severity.

Choice B reason: Cognitive enhancers are not equally effective in all Alzheimer’s stages. Cholinesterase inhibitors benefit mild-to-moderate cases, while memantine is used in severe stages. Their efficacy diminishes in advanced disease due to extensive neuronal loss, making this statement inaccurate, as stage-specific prescribing is critical for therapeutic benefit.

Choice C reason: Medications for anxiety and depression, like SSRIs, remain helpful in Alzheimer’s to manage behavioral symptoms, even with cognitive enhancers. These drugs address mood disorders, which often coexist, improving quality of life. This statement is inaccurate, as combination therapy is common and beneficial in managing neuropsychiatric symptoms.

Choice D reason: Cognitive enhancers are not used for seizure management. Anticonvulsants like levetiracetam manage seizures, which may occur in Alzheimer’s due to neuronal excitability. Cognitive enhancers target cognitive decline via cholinergic or glutamatergic pathways, not seizure control, making this statement inaccurate and unrelated to their pharmacological role.

A. This medication will target the inflammation and pain during an acute attack B. This medication decreases the production of uric acid C. Kidney function tests are not necessary when using this medication D. Limit fluid intake to 1000cc per day to prevent urinary incontinence

Correct Answer is B

Explanation

Choice A reason: Allopurinol does not directly target inflammation or pain in acute gout attacks; it lowers uric acid levels to prevent future attacks. Anti-inflammatories like NSAIDs or colchicine manage acute symptoms. This statement is inaccurate, as allopurinol’s role is preventive, not for acute symptom relief.

Choice B reason: Allopurinol inhibits xanthine oxidase, reducing uric acid production, which prevents urate crystal formation and gout attacks. It is used for long-term management of hyperuricemia. This statement is accurate, as decreased uric acid production is the primary mechanism, critical for patient education on its purpose.

Choice C reason: Kidney function tests are necessary with allopurinol, as it is renally excreted, and impaired renal function can increase toxicity risk (e.g., rash, interstitial nephritis). Monitoring ensures safe use, especially in gout patients with potential renal issues, making this statement inaccurate for discharge instructions.

Choice D reason: Limiting fluid intake to 1000cc daily is inappropriate; high fluid intake (2-3L/day) is recommended with allopurinol to prevent urate kidney stones by diluting urine. This statement is inaccurate, as it contradicts the need for hydration to support uric acid excretion and prevent complications.

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The client’s blood sugar this morning is 50 mg/dL. The client states they are cold, sweating, and clammy. Which nursing intervention is most appropriate?

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