The health care provider suspects the Somogyi effect in a 66-yr-old patient whose 2:00 AM blood glucose is 66 mg/dL. Which action will the nurse teach the patient to take?

Give 15 grams of simple carbs at 3:00am

Have a snack at bedtime.

Increase the insulin dose.

Do nothing, this is normal

Answer and Explanation

The Correct Answer is B

A. Giving carbohydrates at 3:00 AM might prevent hypoglycemia temporarily but does not address the underlying issue.
B. Having a snack at bedtime helps prevent nighttime hypoglycemia, which can lead to rebound hyperglycemia, known as the Somogyi effect.
C. Increasing the insulin dose could exacerbate nocturnal hypoglycemia, worsening the Somogyi effect.
D. Doing nothing is inappropriate as the low 2:00 AM glucose level is a sign of the Somogyi effect.

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Correct Answer is D

Explanation

A. Oral hypoglycemics are not appropriate for managing DKA, as immediate and effective control of blood glucose levels is required through IV insulin.
B. Dextrose solutions are not initially indicated, as they could elevate blood glucose further. Dextrose may be considered once blood glucose reaches a safer level (around 250 mg/dL).
C. Glucocorticoids can increase blood glucose levels, so they are contraindicated in DKA management.
D. 0.9% sodium chloride IV bolus is essential to address dehydration commonly seen in DKA due to osmotic diuresis and to restore blood volume.

A. Ensure the drainage tubing is patent and without obstruction. B. Notify the surgeon if the urine is bright red in appearance or has large clots. C. Add the amount of bladder irrigation to the total output. D. Use sterile technique when preparing the irrigation solution. E. Contact the surgeon if the client reports a continual need to void.

Correct Answer is ["A","B","D","E"]

Explanation

A. Patency of the drainage tubing is crucial to prevent blockage and maintain continuous flow.
B. Bright red urine or large clots could indicate bleeding, requiring immediate notification of the surgeon.
C. The amount of irrigation fluid is usually subtracted from the total output to determine true urine output, not added.
D. Using sterile technique helps prevent infection in a postoperative patient.
E. A continual urge to void could indicate bladder spasms or improper catheter placement, and the surgeon should be contacted.

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The health care provider suspects the Somogyi effect in a 66-yr-old patient whose 2:00 AM blood glucose is 66 mg/dL. Which action will the nurse teach the patient to take?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse in an emergency department is caring for a client who has diabetic ketoacidosis (DKA) and a blood glucose level of 925 mg/dL. The nurse should anticipate which of the following prescriptions from the provider?

Correct Answer is D

Explanation

A nurse is caring for a client who is 1 day postoperative following a transurethral resection of the prostate (TURP) and has a continuous bladder irrigation in place. Which of the following actions should the nurse take? (Select all that apply.)

Correct Answer is ["A","B","D","E"]

Explanation

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