The nurse is evaluating the teaching of self-monitoring of blood glucose levels in a newly diagnosed Type 2 diabetic client. The nurse identifies a need for additional teaching when the client:

Warms the hands with water prior to the procedure.

Alternates fingers used in a systematic manner.

Chooses the center of the finger pad as a puncture site.

Verbalizes that a random result of 115 mg/dL indicates good glucose control.

Answer and Explanation

The Correct Answer is D

Choice a reason:
Warming the hands with water before testing is actually a recommended practice. It helps increase blood flow to the fingertips, making it easier to get a sufficient blood sample for testing. Cold hands can restrict blood flow, leading to difficulty in obtaining a blood sample and potentially inaccurate results.

Choice b reason:
Alternating fingers for blood glucose testing is also a recommended practice. It helps prevent soreness and calluses on the fingers from repeated pricks. Using different fingers or different sides of the same finger can help reduce pain and potential damage to the skin.

Choice c reason:
Choosing the center of the finger pad as a puncture site is not recommended. The sides of the fingertips are preferred because they have fewer nerve endings, making the process less painful. The center of the finger pad has a denser nerve supply and can lead to more discomfort during the test.

Choice d reason:
A random blood glucose result of 115 mg/dL is slightly above the normal range for non-diabetics, which is typically between 70 to 99 mg/dL when fasting. For someone with diabetes, this result might be considered within a target range, depending on individual treatment goals set by healthcare providers. However, it's important to note that a single glucose reading does not provide a complete picture of glucose control. An A1C test, which reflects average blood glucose levels over the past 2-3 months, is also necessary to assess overall glucose management.

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Correct Answer is A

Explanation

Choice A Reason:
A blood glucose level of 80 mg/dL before eating falls within the normal fasting blood glucose range, which is between 70 mg/dL to 110 mg/dL. Therefore, this finding is not a priority concern for a client taking prednisone.

Choice B Reason:
Gaining 5 pounds over 7 months is not typically a priority concern unless it is sudden or unexplained. Prednisone can cause fluid retention and weight gain as a common side effect, but this gradual weight change does not indicate an immediate health risk.

Choice C Reason:
Waking up with a fever is a priority finding as it may indicate an infection. Patients on prednisone are at increased risk of infections due to its immunosuppressive effects¹. Fever could also signify an exacerbation of inflammatory bowel disease or other complications.

Choice D Reason:
While insomnia is a common side effect of prednisone and can impact quality of life, it is not typically a priority over signs that could indicate infection or exacerbation of the underlying condition

A. The fetus is likely to have a congenital anomaly, be growth restricted, or demonstrate fetal distress during labor. B. There is an elevated level of alpha-fetoprotein (AFP) in the amniotic fluid. C. The client is carrying more than one fetus. D. An excessive amount of amniotic fluid is present

Correct Answer is D

Explanation

Choice A reason:

While polyhydramnios can be associated with congenital anomalies or fetal distress, it is not a direct indication of these conditions. Polyhydramnios refers specifically to the excessive accumulation of amniotic fluid. Congenital anomalies may lead to polyhydramnios if they affect the fetus's ability to swallow and process amniotic fluid normally, but the presence of polyhydramnios alone does not confirm these conditions.

Choice B reason:

Elevated levels of alpha-fetoprotein (AFP) in the amniotic fluid can be indicative of neural tube defects or other fetal abnormalities, but they are not a defining characteristic of polyhydramnios. Normal AFP levels in amniotic fluid at 15 to 21 weeks' gestation range from 10 to 150 ng/ml. Polyhydramnios is diagnosed based on the volume of amniotic fluid, not the AFP levels.

Choice C reason:

Carrying more than one fetus can lead to an increased amount of amniotic fluid, potentially resulting in polyhydramnios. However, the diagnosis of polyhydramnios itself does not imply a multiple gestation pregnancy. It simply indicates that there is more amniotic fluid than usual.

Choice D reason:

Polyhydramnios is defined as an excessive amount of amniotic fluid. It is typically diagnosed when the amniotic fluid index (AFI) exceeds 24 cm or the single deepest pocket (SDP) measures more than 8 cm. This condition can occur due to various reasons, including fetal anomalies, maternal diabetes, and other medical conditions.

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The nurse is evaluating the teaching of self-monitoring of blood glucose levels in a newly diagnosed Type 2 diabetic client. The nurse identifies a need for additional teaching when the client:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is assessing a client who has been taking prednisone following an exacerbation of inflammatory bowel disease. Which finding should the nurse recognize as the priority? The client reports:

Correct Answer is A

Explanation

A nurse is caring for a client who was admitted to the maternity unit at 38 weeks of gestation and who is experiencing polyhydramnios. The nurse should understand that this diagnosis means which of the following?

Correct Answer is D

Explanation

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