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The nurse is caring for a patient with diabetes.

Exhibits

Which of the following actions should the nurse take? Select all that apply.

Assess bowel sounds

Obtain blood glucose from the lab

Obtain temperature

Obtain pulse oximeter

Stop insulin drip

Administer dextrose

Assess neurological status

Answer and Explanation

Correct Answer : A,B,C,D,E,F,G

A.   Assess bowel sounds: The patient’s abdomen is soft with hypoactive bowel sounds, which may indicate gastrointestinal hypomotility or early ileus secondary to metabolic derangement or infection. Monitoring bowel sounds is critical for detecting potential complications and guiding treatment.
B.   Obtain blood glucose from the lab: Laboratory glucose measurement confirms bedside findings and helps evaluate trends, ensuring accurate assessment of glycemic status in a critically hypoglycemic patient.
C.   Obtain temperature: Elevated white blood cell count and history of recent illness raise concern for infection, which can precipitate metabolic instability in diabetes. Monitoring temperature aids in identifying infectious processes requiring intervention.
D.   Obtain pulse oximeter: The patient has diminished lung sounds despite oxygen therapy at 2 L/min, suggesting possible respiratory compromise. Continuous pulse oximetry is essential for monitoring oxygenation status.
E.   Stop insulin drip: The patient’s blood glucose of 40 mg/dL indicates severe hypoglycemia; continuing insulin at this point risks worsening neuroglycopenia and potentially fatal outcomes. Immediate cessation of insulin is necessary.
F.   Administer dextrose: IV dextrose administration is the primary treatment for severe hypoglycemia, especially in a lethargic patient unable to take oral carbohydrates. This intervention rapidly restores serum glucose and prevents neurological damage.
G.   Assess neurological status: Lethargy reflects central nervous system impairment from hypoglycemia. Ongoing neurological assessment is crucial to monitor progression and response to treatment.

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Correct Answer is D

Explanation

A. Cocaine: Cocaine use is primarily associated with cardiovascular complications such as arrhythmias, myocardial infarction, and stroke. Although it can cause hepatic ischemia in rare cases, it is not a leading cause of cirrhosis.

B. Inhalants: Inhalants can cause significant damage to the lungs, brain, and kidneys, and can lead to sudden cardiac death, but they are not known to directly cause liver cirrhosis. While some liver stress can occur, inhalants are not a primary hepatotoxic substance linked to chronic liver disease.

C. Caffeine: Caffeine is a central nervous system stimulant with minimal hepatic toxicity when used in moderation. There is no established link between caffeine use and the development of liver cirrhosis. In fact, caffeine may even have protective effects against certain liver conditions.

D. Alcohol: Chronic alcohol use is the most common and well-documented cause of liver cirrhosis. It leads to progressive liver damage through inflammation, fatty liver development, and eventual scarring (fibrosis), which impairs liver function and results in cirrhosis over time.

A. Heart rate is 54, patient has complained of constipation and poor appetite. B. Patient is anxious and irritable with skin moist and warm C. Nonpitting edema noted in the extremities with thinning hair D. Patient has recently lost over 10 pounds in the last month and has noticed a fine tremor in the hands

Correct Answer is {"A":{"answers":"B"},"B":{"answers":"A"},"C":{"answers":"B"},"D":{"answers":"A"}}

Explanation

Heart rate is 54, patient has complained of constipation and poor appetite: Myxedema, a severe form of hypothyroidism, causes bradycardia due to decreased metabolism. Constipation and poor appetite occur as slowed metabolism reduces gastrointestinal motility and hunger.
Patient is anxious and irritable with skin moist and warm: Graves Disease causes hyperthyroidism, increasing metabolic rate and sympathetic activity. This leads to anxiety, irritability, and warm, moist skin from increased blood flow and sweating. These findings show the hypermetabolic state of Graves.
Nonpitting edema noted in the extremities with thinning hair: Nonpitting edema results from mucopolysaccharide buildup in hypothyroidism. Thinning hair occurs due to thyroid hormone deficiency affecting hair follicles. These are classic signs of advanced hypothyroidism.
Patient has recently lost over 10 pounds in the last month and has noticed a fine tremor in the hands: Weight loss despite increased appetite is typical of Graves Disease due to elevated metabolism. Fine hand tremors result from increased beta-adrenergic stimulation. These symptoms indicate hyperthyroidism.

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The nurse is caring for a patient with diabetes. Exhibits Which of the following actions should the nurse take? Select all that apply.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is D

Explanation

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Correct Answer is {"A":{"answers":"B"},"B":{"answers":"A"},"C":{"answers":"B"},"D":{"answers":"A"}}

Explanation

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Exhibits

Which of the following actions should the nurse take? Select all that apply.