The nurse is caring for several clients on a hospital unit. Which of the following clients is most at risk for hypoglycemia?

A client with type 1 diabetes mellitus who has taken a high dose of insulin

A client who has type 2 diabetes and has not taken any medication

An older adult client taking an antibiotic for an infection

A client who has metabolic syndrome and is taking a statin drug to lower cholesterol levels

Answer and Explanation

The Correct Answer is A

Choice A reason: A client with type 1 diabetes mellitus who has taken a high dose of insulin is at significant risk for hypoglycemia. In type 1 diabetes, the body does not produce insulin, so insulin therapy is essential for controlling blood glucose levels. However, if the dose of insulin is too high relative to the patient's dietary intake or physical activity level, it can lead to a rapid decrease in blood glucose levels, resulting in hypoglycemia. Hypoglycemia is defined as a blood glucose level less than 70 mg/dL (3.9 mmol/L) and can cause symptoms such as confusion, sweating, weakness, and in severe cases, seizures or loss of consciousness.

Choice B reason: A client with type 2 diabetes who has not taken any medication may have elevated blood glucose levels but is not typically at immediate risk for hypoglycemia unless they are taking medications that lower blood glucose. Type 2 diabetes is characterized by insulin resistance, and while medication can help manage it, skipping medication does not usually result in hypoglycemia unless other factors are at play.

Choice C reason: An older adult client taking an antibiotic for an infection is not generally at risk for hypoglycemia unless the antibiotic interacts with other medications that the client is taking for diabetes management. Antibiotics themselves do not typically cause hypoglycemia.

Choice D reason: A client who has metabolic syndrome and is taking a statin drug to lower cholesterol levels is not at direct risk for hypoglycemia from the statin medication. Metabolic syndrome is a cluster of conditions that increase the risk for heart disease, stroke, and type 2 diabetes. While statins are used to lower cholesterol levels, they do not have a direct impact on blood glucose levels that would lead to hypoglycemia.

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Correct Answer is B

Explanation

Choice A reason: Thyroidectomy is a surgical procedure that involves the removal of all or part of the thyroid gland. While there are risks associated with any surgery, thyroidectomy is not typically associated with fat embolism syndrome (FES). FES is more commonly linked to orthopedic procedures and trauma, particularly those involving long bones.

Choice B reason: Internal fixation of a fractured hip is a procedure that carries a risk for developing FES. FES is a serious and potentially life-threatening condition that occurs when fat globules enter the bloodstream and lodge within the blood vessels of the lungs or other organs. Hip fractures, especially those involving the long bones, can result in the release of fat globules into the bloodstream during the surgical repair process. Early surgical fixation is thought to reduce the risk of FES.

Choice C reason: Repair of a torn rotator cuff involves the shoulder joint and, while it is a significant surgical procedure, it is not typically associated with a high risk of FES. The rotator cuff is composed of muscles and tendons, and its repair does not usually involve manipulation of the long bones where fat embolism is more likely to occur.

Choice D reason: Tympanoplasty is a surgical procedure to repair a hole in the eardrum. It is an otologic procedure that does not involve the long bones or orthopedic manipulation. Therefore, it is not associated with a risk of developing FES.

A. "Display a monthly calendar in the client's room." B. "Provide plenty of stimulation in the client's room." C. "Keep the client's room dark at night to promote sleep." D. "Provide the client with structured activities to fill their time."

Correct Answer is D

Explanation

Choice A reason:A monthly calendar is often too complex and overwhelming for a client with Alzheimer’s. A single-day calendar or a daily schedule that can be marked off is much more effective for orientation.

Choice B reason: Providing plenty of stimulation can be overwhelming for clients with Alzheimer's disease. A calm and predictable environment is usually more beneficial.

Choice C reason: Keeping the room dark at night can promote sleep, but it is not the only consideration. A nightlight or low-level lighting can prevent falls if the client needs to get up during the night.

Choice D reason:When caring for a client with Alzheimer’s disease, the goal of nursing intervention is to maintain a safe, predictable environment that minimizes confusion and anxiety while maximizing the client's remaining functional abilities.

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The nurse is caring for several clients on a hospital unit. Which of the following clients is most at risk for hypoglycemia?

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