The nurse is admitting a patient with type 1 diabetes. While reviewing the patient's laboratory results, the nurse notes the presence of ketones in the urine. What intervention will the nurse implement for this patient?

Advise the patient to consume protein and carbohydrates immediately.

Notify the provider of the result and recommend that the patient's insulin dose be increased.

Instruct the patient to withhold the next scheduled dose of insulin.

Suggest that the patient asks their provider to start them on metformin therapy.

Answer and Explanation

The Correct Answer is B

Choice A reason: Advising the patient to consume protein and carbohydrates immediately is not appropriate in this context. The presence of ketones in the urine indicates that the body is using fat for energy due to a lack of insulin. Increasing carbohydrate intake without addressing the underlying insulin deficiency can worsen hyperglycemia and ketoacidosis.

Choice B reason: Notifying the provider of the result and recommending that the patient's insulin dose be increased is the appropriate intervention. The presence of ketones in the urine indicates inadequate insulin levels, and adjusting the insulin dose can help correct the metabolic imbalance and prevent further complications such as diabetic ketoacidosis.

Choice C reason: Instructing the patient to withhold the next scheduled dose of insulin is incorrect. Insulin is essential for managing blood glucose levels and preventing ketosis in patients with type 1 diabetes. Withholding insulin can lead to severe hyperglycemia and ketoacidosis.

Choice D reason: Suggesting that the patient ask their provider to start them on metformin therapy is not appropriate for type 1 diabetes. Metformin is used primarily for type 2 diabetes and is not effective in type 1 diabetes, where insulin is required for glucose management.

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Correct Answer is B

Explanation

Choice A reason: Administering a platelet transfusion immediately is not indicated for a platelet count of 45,000/mm³. While this is below the normal range, it is not critically low. Platelet transfusions are typically reserved for patients with life-threatening bleeding or extremely low platelet counts.

Choice B reason: Monitoring the patient for signs of bleeding and educating about bleeding precautions is the appropriate intervention. Patients with thrombocytopenia are at an increased risk of bleeding, and it is essential to educate them on how to minimize this risk, such as avoiding activities that can cause injury, using a soft toothbrush, and avoiding over-the-counter medications that can affect platelet function.

Choice C reason: Administering aspirin to reduce the risk of clot formation is incorrect. Aspirin is an antiplatelet agent that can increase the risk of bleeding in patients with thrombocytopenia. It should be avoided unless specifically prescribed for another condition with close monitoring.

Choice D reason: Encouraging the patient to engage in regular physical exercise to improve circulation is not appropriate in this context. While physical activity is generally beneficial, it should be done with caution in patients with thrombocytopenia to avoid injury and bleeding. The focus should be on safety and bleeding precautions.

A. "I will take this medication as needed during flares of joint pain." B. "I will avoid drinking alcohol while taking this medication." C. "I will call my provider if I develop a sore throat or fever." D. "I will use contraception while taking this medication."

Correct Answer is A

Explanation

Choice A reason: Methotrexate is a disease-modifying antirheumatic drug (DMARD) that must be taken regularly as prescribed, not just during flares of joint pain. It helps to prevent disease progression and joint damage. This statement indicates a misunderstanding of the medication regimen and requires further teaching.

Choice B reason: Avoiding drinking alcohol while taking methotrexate is important because alcohol can increase the risk of liver damage, a potential side effect of methotrexate. This statement indicates proper understanding.

Choice C reason: Calling the provider if a sore throat or fever develops is important because methotrexate can suppress the immune system, increasing the risk of infections. This statement indicates proper understanding.

Choice D reason: Using contraception while taking methotrexate is crucial because methotrexate can cause birth defects. This statement indicates proper understanding.

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The nurse is admitting a patient with type 1 diabetes. While reviewing the patient's laboratory results, the nurse notes the presence of ketones in the urine. What intervention will the nurse implement for this patient?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is caring for a patient with thrombocytopenia who has a platelet count of 45,000/mm³. What nursing intervention will the nurse implement to manage this condition?

Correct Answer is B

Explanation

The nurse is providing discharge teaching to a patient with rheumatoid arthritis (RA) who has been prescribed methotrexate. Which patient statement indicates to the nurse a need for further teaching?

Correct Answer is A

Explanation

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