The nurse is caring for a client with type 2 diabetes mellitus who reports frequent episodes of hypoglycemia. Which action should the nurse prioritize?

Increase carbohydrate intake at meals

Review the client’s medication regimen

Monitor blood glucose every hour

Encourage high-protein snacks

Answer and Explanation

The Correct Answer is B

Choice A reason: Increasing carbohydrate intake may prevent hypoglycemia but does not address the root cause, such as excessive insulin or oral hypoglycemic agents. Reviewing medications identifies dosing issues, ensuring safer management of type 2 diabetes, making it the priority over dietary changes.

Choice B reason: Reviewing the medication regimen is critical, as hypoglycemia in type 2 diabetes often results from excessive insulin or sulfonylureas. Adjusting doses or timing with a provider prevents recurrent episodes, addressing the primary cause and ensuring safe glycemic control, making it the priority action.

Choice C reason: Monitoring blood glucose hourly is reactive and impractical long-term. It confirms hypoglycemia but does not prevent it. Reviewing medications addresses the cause, such as inappropriate dosing, making it more effective for managing recurrent hypoglycemia in type 2 diabetes.

Choice D reason: High-protein snacks stabilize blood glucose but are secondary to addressing medication-related hypoglycemia. Excessive insulin or oral agents are likely causes, so reviewing the regimen is prioritized to correct dosing, preventing recurrent episodes more effectively than dietary adjustments alone.

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Correct Answer is A

Explanation

Choice A reason: Topical corticosteroids reduce inflammation, scaling, and itching in psoriasis by inhibiting pro-inflammatory cytokines and immune responses in affected skin. They are first-line for plaque psoriasis with silvery scales, effectively managing burning and promoting healing of inflamed, bleeding areas on elbows and palms.

Choice B reason: Topical analgesics relieve pain but do not address psoriasis’s underlying inflammation or scaling. Psoriatic plaques are primarily inflammatory, not neuropathic. Analgesics may reduce burning temporarily but lack the anti-inflammatory action of corticosteroids, making them ineffective for managing chronic psoriatic lesions.

Choice C reason: Topical antibiotics treat bacterial infections, not psoriasis, which is an autoimmune inflammatory condition. Bleeding in psoriasis results from skin fragility, not infection. Antibiotics are unnecessary unless secondary infection is confirmed, making them inappropriate compared to corticosteroids, which target the disease’s inflammatory pathology.

Choice D reason: Colloidal oatmeal-based lotion soothes irritated skin and reduces itching but lacks anti-inflammatory properties to treat psoriasis’s scaling and inflammation. It may provide symptomatic relief but is inadequate for managing chronic plaques, unlike corticosteroids, which directly address the autoimmune-driven inflammation and scaling.

A. Reduce dietary sodium intake B. Increase saturated fat consumption C. Limit physical activity D. Encourage smoking cessation only if symptomatic

Correct Answer is A

Explanation

Choice A reason: Reducing dietary sodium lowers blood pressure in hypertension by decreasing vascular fluid volume and vasoconstriction. Sodium restriction (e.g., <2.3 g/day) reduces cardiac workload, preventing complications like heart failure, making it the priority lifestyle modification for effective blood pressure control.

Choice B reason: Increasing saturated fat consumption worsens hypertension by promoting atherosclerosis and vascular stiffness. Sodium reduction is critical, as it directly lowers blood volume and pressure, reducing cardiovascular risk, making it the priority over dietary fat adjustments in hypertension management.

Choice C reason: Limiting physical activity is incorrect, as exercise lowers blood pressure by improving vascular elasticity. Sodium reduction is the priority, as it directly reduces fluid retention and vasoconstriction, providing immediate blood pressure control, making it essential for hypertension management.

Choice D reason: Smoking cessation is beneficial but not the primary focus unless active smoking is confirmed. Sodium reduction directly lowers blood pressure by decreasing fluid volume, making it the priority lifestyle change, as it addresses hypertension’s core mechanism more effectively.

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The nurse is caring for a client with type 2 diabetes mellitus who reports frequent episodes of hypoglycemia. Which action should the nurse prioritize?

Nursing Test Bank

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Explanation

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