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.

Nursing Test Bank

Quiz #1: RN Exams Pharmacology Exams Quiz #2: RN Exams Medical-Surgical Exams Quiz #3: RN Exams Fundamentals Exams Quiz #4: RN Exams Maternal-Newborn Exams Quiz #5: RN Exams Anatomy and Physiology Exams Quiz #6: RN Exams Obstetrics and Pediatrics Exams Quiz #7: RN Exams Fluid and Electrolytes Exams Quiz #8: RN Exams Community Health Exams Quiz #9: RN Exams Promoting Health across the lifespan Exams Quiz #10: RN Exams Multidimensional care Exams

Get 100+ Naxlex Exit Exams for $79 Try Naxlex NCLEX-RN (14 Day Free-Trial)

Naxlex Comprehensive Predictor Exams

Quiz #1: Naxlex RN Comprehensive online practice 2019 B with NGN Quiz #2: Naxlex RN Comprehensive Predictor 2023 Quiz #3: Naxlex RN Comprehensive Predictor 2023 Exit Exam A Quiz #4: Naxlex HESI Exit LPN Exam Quiz #5: Naxlex PN Comprehensive Predictor PN 2020 Quiz #6: Naxlex VATI PN Comprehensive Predictor 2020 Quiz #8: Naxlex PN Comprehensive Predictor 2023 - Exam 1 Quiz #10: Naxlex HESI PN Exit exam Quiz #11: Naxlex HESI PN EXIT Exam 2

Free Nursing Study Resources

Correct Answer is B

Explanation

A. Bedtime snacks are often recommended for clients using insulin to help prevent nighttime hypoglycemia, especially if they are taking insulin that has a peak action during the night (e.g., NPH insulin).
B. The timing of food intake should not necessarily coincide with the peak action of the insulin. For example, rapid-acting insulins should be given around meal times, but the timing of food isn't strictly tied to the insulin peak. It's more important to match the insulin to meal timing to help with glucose control.
C. When mixing NPH (a longer-acting insulin) and regular insulin (a shorter-acting insulin), the correct technique is to draw up the regular insulin first to avoid contamination of the regular insulin with the NPH insulin, which is cloudy.
D. Educating clients about the signs, symptoms, and management of hypoglycemia is essential to safe insulin therapy.

A. Administer prescribed morphine sulphate. B. Stop thyroid hormone administration. C. Obtain serum cardiac enzymes. D. Complete a pain assessment.

Correct Answer is D

Explanation

A. While morphine may be indicated for pain management, particularly if the pain is severe, the priority is first to assess the cause of the chest pain. Chest pain in a patient with myxedema could be related to a number of serious conditions, such as a myocardial infarction or worsening cardiovascular issues, so it is important to assess the pain thoroughly before administering any medications.
B. Stopping thyroid hormone administration is not the correct action. Myxedema is a severe form of hypothyroidism, and thyroid hormone therapy is essential in treating this condition. However, if there is a concern about the cause of the chest pain (such as a heart attack), stopping the thyroid hormone might not be appropriate unless directly indicated by a physician.
C. While obtaining cardiac enzymes can be an important diagnostic step if the chest pain is suspected to be related to a cardiac event, the priority at this moment is to assess the pain and clinical presentation more thoroughly. Cardiac enzymes can be checked after a full assessment of the symptoms.
D. The first priority is to complete a comprehensive pain assessment. The nurse should assess the quality, intensity, and duration of the chest pain and ask relevant questions to determine if the pain is cardiac in nature (e.g., tightness, radiating to left arm, sweating) or possibly related to the thyroid condition (e.g., could be related to complications of myxedema, such as hypothyroid-induced cardiac dysfunction). This step is critical to understanding the cause and ensuring appropriate next steps for care.

View Question and Answer

Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.

Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today

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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse attended a staff education conference about insulin therapy for diabetic management. Which of the following statements by the nurse would indicate that more education is needed?

Correct Answer is B

Explanation

The nurse is caring for a client during treatment of myxedema and the client reports experiencing chest pain. Which of the following actions should be a priority for the nurse to take?

Correct Answer is D

Explanation

The nurse is obtaining a medical history from a client scheduled for a thyroid diagnostic test. Which of the following findings may affect the results?

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?

The nurse is caring for a client who experienced a seizure. The nurse knows which of the following is NOT a risk factors for seizure activity?

The nurse is reviewing the hemoglobin A1C (HgbA1C) results that showed 6.9% with a client who has diabetes mellitus. The client asked the nurse what the result means. Which of the following statements by the nurse is correct?

The nurse is teaching a client about diabetic ketoacidosis (DKA). Which of the following types of diabetes does the client most likely have?

The nurse is planning care for a client experiencing headaches. Which of the following interventions should the nurse include in the client's plan of care? Select all that apply.

The nurse is administering prescribed lispro (Humalog) to a client with diabetes mellitus, type 2. The nurse should administer the insulin at which of the following times?