The physician orders a 1,800-calorie diabetic diet and 40 units of Humulin N insulin (an intermediate-acting insulin) administered subcutaneously @ 0700 for a patient with diabetes mellitus. A mid-afternoon snack of milk and crackers is given to

prevent diabetic coma

improve nutrition

improve carbohydrate metabolism

prevent an insulin reaction

Answer and Explanation

The Correct Answer is D

A. Prevent diabetic coma: A diabetic coma (such as diabetic ketoacidosis or hyperosmolar hyperglycemic state) is not the primary concern related to insulin administration. It is associated with severe hyperglycemia, not with the need for a snack to balance insulin action.

B. Improve nutrition: While the snack may help with overall nutrition, it is not primarily intended to improve nutrition in this scenario. The goal is to maintain blood sugar levels within a safe range, particularly after insulin administration.

C. Improve carbohydrate metabolism: The primary goal of the mid-afternoon snack is not to directly impact carbohydrate metabolism. The snack is designed to maintain glucose levels after insulin has been administered.

D. Prevent an insulin reaction: The snack is likely provided to prevent hypoglycemia or an insulin reaction (low blood sugar). Humulin N insulin is an intermediate-acting insulin, and its peak action occurs several hours after administration. The snack helps prevent low blood sugar by providing a source of glucose to balance the insulin effect.

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Correct Answer is A

Explanation

A. Fowler's: Fowler's position (sitting or semi-sitting) position helps reduce swelling in the neck area, facilitates breathing, and promotes comfort. It also helps in the prevention of respiratory distress due to potential swelling around the surgical site.

B. Trendelenburg: Trendelenburg position (head down, feet elevated) is typically used for shock or hypotension, but it is not appropriate for a patient recovering from thyroid surgery. It can increase pressure on the neck and exacerbate swelling.

C. Supine: Lying flat on the back (supine) is not recommended post-thyroidectomy as it can lead to neck swelling and compromise the airway. It is better to keep the patient in a more elevated position to reduce the risk of respiratory distress.

D. Prone: The prone position (lying on the stomach) is not appropriate after thyroid surgery, as it could place unnecessary pressure on the neck and surgical site, potentially hindering recovery and breathing.

A. Sore throat B. Excitability C. Muscle aches D. Weight loss

Correct Answer is A

Explanation

A. Sore throat: A sore throat could be a sign of agranulocytosis, a serious side effect of propylthiouracil (PTU), which can lower the white blood cell count, leading to a weakened immune system. It is essential to report this symptom to the physician immediately, as this may indicate a need for discontinuing the medication or adjusting the treatment plan.

B. Excitability: Excitability is not typically a serious side effect of PTU. In fact, hyperthyroidism itself can cause symptoms like anxiety and nervousness, but these are not as critical as other potential adverse effects like agranulocytosis.

C. Muscle aches: While muscle aches can occur in people with hyperthyroidism or as a side effect of medications, they are not as concerning as sore throat in the case of PTU therapy. Muscle aches are more common in hypothyroid conditions or as a non-specific symptom.

D. Weight loss: Weight loss can be a symptom of hyperthyroidism, but it is not as urgent as the potential for agranulocytosis and is not a reason to immediately report to the physician unless it is extreme or accompanied by other symptoms of serious complications.

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The physician orders a 1,800-calorie diabetic diet and 40 units of Humulin N insulin (an intermediate-acting insulin) administered subcutaneously @ 0700 for a patient with diabetes mellitus. A mid-afternoon snack of milk and crackers is given to

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is A

Explanation

A client diagnosed with hyperthyroidism will be taking propylthiouracil (PTU). The nurse provides medication instructions and determines that the client understands the information if the client states that it is most important to report which of the following symptoms to the physician?

Correct Answer is A

Explanation

The nurse is teaching a client who has been prescribed sitagliptin (Januvia) for type 2 diabetes. Which statement by the client indicates a need for further teaching?

The patient comes to the emergency room with dry hot skin, fruity breath, and deep respirations and is complaining of abdominal pain. The nurse interprets these signs and symptoms as:

After teaching a client who is recovering from a complete thyroidectomy, the nurse assesses the client's understanding. Which statement made by the client indicates a need for additional instruction?

The nurse is discussing insulin administration with an assigned patient. The patient reports that she prefers to use only certain sites for insulin injections. The patient questions why rotation of the sites is important. What response by the nurse is most appropriate?

A mother reports that her 4-month-old infant is lethargic, sleeps 18 hours a day, and snores. The nurse recognizes these signs are characteristic of what?

When assisting with the development of a care plan for a client with hyperthyroidism, the nurse would anticipate which treatment?

A client has flushed skin, bulging eyes and perspiration, and states that he has been "irritable" and having palpitations. The nurse interprets these findings as suggesting:

When a patient who is 8 hours postoperative from a total thyroidectomy shows a positive Chvostek's sign and complains of muscle cramps, the nurse interprets these assessments as indicative of: