The home health nurse is visiting a client with diabetes mellitus, type 2 who reports nausea and vomiting for the past 3 days and not taking prescribed insulin because of the inability to "keep food down." Which of the following responses would be most appropriate for the nurse to make?

"Continue taking your usual insulin dose even if you have nausea and vomiting."

"Check your blood sugar level twice each day even if you are not eating."

"Avoid drinking soda or fruit juices because it will increase your blood sugar level."

"Limit your daily fluid intake as it may aggravate your nausea and vomiting.

Answer and Explanation

The Correct Answer is A

A. It is important for the client with diabetes to continue taking their insulin as prescribed, even if they are unable to eat. When the body is under stress (e.g., due to illness), blood sugar levels can rise, and insulin is still necessary to manage glucose levels. Skipping insulin could lead to hyperglycemia or diabetic ketoacidosis (DKA), which can be life-threatening. The nurse should encourage the client to continue insulin therapy and consider alternative ways to manage nausea (e.g., antiemetics).
B. While it is important for the client to monitor their blood glucose, checking it twice a day may not be sufficient during illness. The client should check their blood glucose more frequently (e.g., every 4 hours) to avoid the risk of hyperglycemia or DKA, especially if they are not eating or drinking regularly.
C. When a person with diabetes is ill and unable to eat, it is important to ensure they stay hydrated and maintain glucose levels. Clear liquids such as soda or fruit juice may help with hydration and provide a quick source of sugar if the blood glucose drops too low, though they should be consumed in moderation.
D. It is essential for the client to stay hydrated, especially if they are vomiting. Dehydration can worsen blood sugar control and lead to further complications. The client should be encouraged to drink small, frequent sips of water or electrolyte solutions to stay hydrated.

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Correct Answer is A

Explanation

A. Look directly at the person you are talking to helps enhance communication by using facial expressions and visual cues, which can compensate for the soft, monotone, or slurred speech often seen in clients with Parkinson’s disease.
B. Stopping to take a breath after each word would make speech more fragmented and harder to follow. It is not a recommended strategy.
C. A hearing aid would help the listener if they had hearing loss, but it does not assist the client with Parkinson’s who is having difficulty speaking, not hearing.
D. Speaking louder may help, but speaking faster is counterproductive. Clients with Parkinson’s often benefit from slower, more deliberate speech and may work with a speech therapist to use strategies like the Lee Silverman Voice Treatment (LSVT), which focuses on increasing vocal loudness—not speed.

A. "Elevated blood sugar level causes decreased thirst and appetite." B. "Increased appetite is due to osmotic factors resulting from high blood sugar. C. "Increased appetite is caused by the increased anabolic state due to high blood sugar. D. "Frequent urination seen in diabetes is due to an elevated blood sugar level."

Correct Answer is D

Explanation

A. Elevated blood sugar (hyperglycemia) typically causes increased thirst (polydipsia) and increased appetite (polyphagia), not decreased thirst and appetite. This occurs due to the body’s attempt to compensate for the excess glucose in the blood.
B. While osmotic factors (such as increased glucose in the urine) contribute to dehydration and increased thirst, increased appetite (polyphagia) in diabetes is primarily caused by the body's inability to effectively use glucose, leading to a sensation of hunger despite high blood sugar.
C. The increased appetite in diabetes is related to the body’s inability to properly utilize glucose, not an anabolic state. The body compensates for the perceived lack of energy, leading to hunger.
D. Frequent urination (polyuria) in diabetes is due to the osmotic diuresis caused by elevated blood sugar levels. When blood glucose levels exceed the renal threshold, glucose spills into the urine, which pulls water along with it, leading to increased urination.

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The home health nurse is visiting a client with diabetes mellitus, type 2 who reports nausea and vomiting for the past 3 days and not taking prescribed insulin because of the inability to "keep food down." Which of the following responses would be most appropriate for the nurse to make?

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Naxlex Comprehensive Predictor Exams

The nurse is caring for a client with Parkinson's disease who has difficulty speaking. Which of the following instructions should the nurse provide to the client.

Correct Answer is A

Explanation

The nurse is developing a staff education program about diabetes mellitus, type 2. Which of the following statements should the nurse include in the program?

Correct Answer is D

Explanation

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