The nurse instructs a client with type 1 diabetes on the amount of carbohydrates in food items. Which statement(s) indicates to the nurse that teaching was effective? Select all that apply.

"Pasta is not a carbohydrate so I can eat as much as I want."

"One slice of bread is a serving of carbohydrates."

"A standard can of a soft drink is 15 grams of carbohydrates."

"A small piece of fruit is considered a serving of carbohydrates."

"Vegetables are not included as a carbohydrate with meals."

Answer and Explanation

Correct Answer : B,D

Brief introduction:

Type 1 diabetes necessitates precise carbohydrate counting to balance exogenous insulin with postprandial glycemic excursions. A single carbohydrate exchange typically contains 15 grams, and maintaining a consistent intake helps prevent ketoacidosis while stabilizing blood glucose levels within the target therapeutic range of 70 to 130 mg/dL.

Rationale:

A. Pasta is a complex carbohydrate that significantly impacts blood sugar levels. Classifying it as a non-carbohydrate food is a dangerous misunderstanding that would lead to severe hyperglycemia, as pasta is calorie-dense and requires careful measurement to match insulin coverage to the actual serving size.

B. A single slice of bread is a standardized unit containing approximately 15 grams of starch. This identification demonstrates the client’s ability to recognize portion sizes, which is foundational for calculating the appropriate bolus insulin dose required to manage the carbohydrate load of a meal.

C. A standard 12-ounce soft drink contains approximately 35 to 40 grams of carbohydrates, not 15. Underestimating the sugar content in liquid calories would result in a significant under-dosing of rapid-acting insulin, causing a rapid and sustained rise in the client's blood glucose concentration.

D. A small piece of fresh fruit serves as a discrete fructose source representing one carbohydrate exchange. Recognizing that fruit contributes to the total carbohydrate count is essential for nutritional compliance, ensuring the client avoids unexpected hyperglycemia by accounting for all sugar-containing food groups accurately.

E. While many non-starchy vegetables are low in calories, they still contain measurable carbohydrates. Excluding vegetables from the meal total ignores their contribution to the total macronutrient profile, which can interfere with the precision required for maintaining tight glycemic control in insulin-dependent patients.

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Correct Answer is ["A","B","C","E","F"]

Explanation

Brief introduction:

Asthma is a chronic inflammatory airway disorder characterized by reversible bronchial hyperresponsiveness and airway narrowing. During an acute exacerbation, the clinical presentation reflects the body’s struggle to maintain adequate ventilation and oxygenation. When a client presents with symptoms that do not respond to initial rescue inhalers (albuterol), it indicates a potentially life-threatening event, such as status asthmaticus, requiring aggressive intervention to prevent respiratory failure.

Rationale for correct answers:

She has mild subcostal retractions and is sitting in an upright position: Retractions indicate the use of accessory muscles to breathe, signaling significant respiratory distress. Sitting upright (often in a tripod position) is a compensatory mechanism to maximize lung expansion and ease the work of breathing.
Wheezes are noted throughout the lung fields: High-pitched whistling sounds indicate significant airway narrowing and turbulence. While wheezing is expected in asthma, the fact that it is present throughout the lung fields after multiple doses of albuterol indicates the treatment has not yet resolved the obstruction.
The client is pale: Pallor in an acute respiratory context can be a sign of poor peripheral perfusion or early hypoxia. It suggests that the respiratory distress is beginning to have a systemic impact.
Her heart rate is 122 beats/minute: Tachycardia in this client is likely due to two factors: the physiological stress of hypoxia/distress and a known side effect of the multiple doses of albuterol (a beta-agonist) she received. This requires monitoring to ensure the heart rate stabilizes as the respiratory status improves.
Oxygen saturation 91% on room air: This is below the target range (typically >94% for most patients, or >92% in some protocols). A saturation of 91% indicates mild to moderate hypoxemia and necessitates the immediate administration of supplemental oxygen.

Rationale for incorrect answer:

She has strong peripheral pulses that are equal bilaterally: This is a normal/reassuring finding. It indicates that despite the respiratory distress, the client's circulatory volume and peripheral perfusion (aside from the noted pallor) remain intact for the moment.

A. Maintain NPO until bowel sounds return. B. Monitor telemetry for dysrhythmias. C. Ambulate once vital signs stable. D. Apply a sequential compression device.

Correct Answer is B

Explanation

Brief introduction:

Cardiac catheterization is an invasive diagnostic procedure used to evaluate coronary artery patency and intracardiac pressures. The introduction of catheters into the heart chambers can irritate the myocardium and conduction system, potentially triggering ectopic beats or lethal electrical instabilities during the immediate post-procedural recovery phase.

Rationale:

A. Maintaining NPO status until the return of bowel sounds is typically reserved for patients recovering from abdominal surgery involving general anesthesia. Since cardiac catheterization is performed under conscious sedation, the client can usually resume oral intake once they are fully awake and their gag reflex is confirmed.

B. Monitoring telemetry is a priority because the heart is highly irritable following mechanical stimulation from the catheter. The nurse must watch for PVCs, ventricular tachycardia, or conduction blocks that could result from myocardial trauma or contrast-induced changes in electrolyte balance within the cardiac myocytes.

C. Ambulating the client as soon as vital signs are stable is contraindicated due to the risk of arterial hemorrhage. To ensure the integrity of the femoral access site and prevent the formation of a hematoma or pseudoaneurysm, the client must remain on strict bedrest for 2 to 6 hours.

D. Applying a sequential compression device (SCD) to the affected leg is avoided because the limb must remain completely immobile. The pressure and movement associated with the inflation cycles of an SCD could disturb the fibrin plug at the puncture site, leading to significant retroperitoneal bleeding.

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The nurse instructs a client with type 1 diabetes on the amount of carbohydrates in food items. Which statement(s) indicates to the nurse that teaching was effective? Select all that apply.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is ["A","B","C","E","F"]

Explanation

Following a cardiac catheterization, an adult client is sent to the cardiovascular unit. The nurse instructs the client to keep the affected leg immobile. Which intervention should the nurse plan to include in this client's plan of care?

Correct Answer is B

Explanation

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The nurse instructs a client with type 1 diabetes on the amount of carbohydrates in food items. Which statement(s) indicates to the nurse that teaching was effective? Select all that apply.

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