The nurse is caring for a client newly diagnosed with diabetes mellitus who states, "I do not understand why I have diabetes when I try not to eat a lot of sugar." Which of the following responses should the nurse make?

Your pancreas is not secreting enough insulin to help regulate your blood sugar level.

Your pancreas is not breaking down glycogen that leads to increased blood sugar level.

Your liver is secreting too much glucagon and that leads to increased blood sugar level.

Your liver is absorbing too much insulin that is why it cannot be used by the blood.

Answer and Explanation

The Correct Answer is A

A. In type 1 diabetes, the pancreas either does not produce any insulin or produces very little insulin. Insulin is necessary to help regulate blood sugar levels by allowing glucose to enter cells. In type 2 diabetes, the body may not respond to insulin effectively (insulin resistance), or the pancreas may not produce enough insulin to meet the body's needs. Either way, insulin production or function is impaired, leading to elevated blood sugar levels.
B. The pancreas does not break down glycogen. Instead, the liver breaks down glycogen into glucose when blood sugar is low. The pancreas's role in diabetes is primarily related to insulin production or secretion, not the breakdown of glycogen.
C. Glucagon is a hormone produced by the pancreas that signals the liver to release glucose when blood sugar is low. In diabetes, the issue is typically with insulin production or the body’s response to insulin, not an overproduction of glucagon.
D. This statement is confusing. The liver does not absorb insulin. In type 2 diabetes, the problem is typically insulin resistance, meaning the body’s cells, including those in the liver, do not respond properly to insulin. In type 1 diabetes, the issue is a lack of insulin production.

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Correct Answer is A

Explanation

A. Phenytoin (Dilantin) is known to cause gingival hyperplasia (gum overgrowth), so it is important for the client to maintain good oral hygiene to help reduce the risk of this side effect. Regular brushing, flossing, and dental check-ups are recommended to help manage and prevent gum problems.
B. Phenytoin has a narrow therapeutic index, meaning that small changes in the dose or blood levels of the drug can have significant effects. Switching between brand name and generic forms of phenytoin may lead to variations in drug absorption, potentially affecting the client’s seizure control. The client should use the same brand unless instructed otherwise by their healthcare provider.
C. Phenytoin is not considered safe during pregnancy due to the risk of birth defects (e.g., fetal hydantoin syndrome). Women who are pregnant or planning to become pregnant should discuss alternative treatments with their healthcare provider.
D. Phenytoin can be taken with food to reduce gastrointestinal irritation. It is important to follow the specific instructions provided by the healthcare provider or pharmacist.

A. "I will use the first drop of blood for my sample" B. "I will poke in the center of the pad of my finger to obtain a sample for testing" C. "I will apply a cold compress on my fingers if I cannot collect any blood" D. "I will make sure I have clean hands prior to testing"

Correct Answer is D

Explanation

A. It is generally recommended to discard the first drop of blood when testing with a glucometer because it may be diluted with tissue fluid, leading to inaccurate results. The second drop should be used for the sample.
B. The center of the fingertip should be avoided for testing because it contains more nerve endings and can be more painful. It is better to poke the sides of the fingertip for a less painful experience.
C. A cold compress may cause blood vessels to constrict, making it even harder to obtain a blood sample. Gentle massaging of the finger or warming the hands may help with blood flow.
D. It is important to wash hands before testing to ensure that the blood sample is not contaminated with food residues, dirt, or other substances that could affect the accuracy of the glucose reading.

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The nurse is caring for a client newly diagnosed with diabetes mellitus who states, "I do not understand why I have diabetes when I try not to eat a lot of sugar." Which of the following responses should the nurse make?

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Naxlex Comprehensive Predictor Exams

The nurse is teaching a client with epilepsy who has a new prescription for phenytoin (Dilantin). Which of the following instructions should the nurse include in the teaching?

Correct Answer is A

Explanation

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Correct Answer is D

Explanation

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