When Jo returns home, the nurse provides education about long-term complications. The nurse explains the importance of annual/yearly screenings, such as eye exams and...

Foot inspection

Serum creatinine (Cr)

Chest X-ray

White blood cell count (WBC)

Answer and Explanation

Correct Answer : B,C

Choice A reason: Foot inspection is not an annual/yearly screening, but a daily self-care practice for people with diabetes. Foot inspection involves checking the feet for any signs of injury, infection, or ulceration, such as cuts, blisters, redness, swelling, or drainage. Foot inspection can help prevent or detect foot problems, such as neuropathy, ischemia, or infection, which can lead to amputation if left untreated. The nurse should teach Jo how to inspect his feet every day, and how to care for his feet, such as washing, drying, moisturizing, trimming nails, and wearing proper footwear.

Choice B reason: Serum creatinine (Cr) is an annual/yearly screening for people with diabetes. Serum creatinine is a blood test that measures the level of creatinine, a waste product that is filtered by the kidneys. Serum creatinine can indicate the kidney function, and detect kidney damage or disease, which is a common complication of diabetes. The nurse should explain to Jo that he needs to have his serum creatinine checked every year, and that he should keep his blood glucose and blood pressure under control, as these are the main risk factors for kidney problems.

Choice C reason: Chest X-ray is not an annual/yearly screening for people with diabetes, unless they have symptoms or risk factors for lung diseases, such as tuberculosis, pneumonia, or cancer. Chest X-ray is an imaging test that uses X-rays to produce pictures of the lungs and the chest cavity. Chest X-ray can help diagnose or monitor lung conditions, such as infections, inflammations, or tumors. The nurse should ask Jo about his history of smoking, exposure to environmental pollutants, or respiratory symptoms, such as cough, shortness of breath, or chest pain, and refer him to a doctor if he needs a chest X-ray.

Choice D reason: White blood cell count (WBC) is not an annual/yearly screening for people with diabetes, unless they have signs or risk factors for infections, such as fever, wounds, or immunosuppression. White blood cell count is a blood test that measures the number and types of white blood cells, which are the cells that fight infections and inflammation. White blood cell count can help diagnose or monitor infections, such as bacterial, viral, or fungal infections, or immune disorders, such as allergies, autoimmune diseases, or cancers. The nurse should assess Jo for any signs of infection, such as fever, chills, malaise, or pus, and advise him to seek medical attention if he has any.

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Correct Answer is A

Explanation

Choice A reason: I will need to take medication by mouth until my blood sugar is within normal limits again is an incorrect statement that indicates the need for further teaching. Type 1 diabetes mellitus (DM) is a condition where the pancreas does not produce any insulin, a hormone that helps the cells use glucose for energy. Patients with type 1 DM need to take insulin injections or use an insulin pump for life to replace the missing hormone. Oral medications for diabetes are not effective for type 1 DM, as they work by stimulating the pancreas to produce more insulin or by increasing the sensitivity of the cells to insulin.

Choice B reason: If I get the flu, the dose of my insulin may need to be altered to control my blood glucose is a correct statement that shows understanding of the disease process. Illnesses such as the flu can increase the blood glucose level, as the body releases hormones that counteract the effects of insulin. Patients with type 1 DM may need to adjust their insulin dose, monitor their blood glucose more frequently, and check for ketones in their urine or blood when they are sick. Ketones are acidic substances that are produced when the body breaks down fat for energy, and can lead to a serious complication called diabetic ketoacidosis.

Choice C reason: I will monitor my blood glucose to help determine whether my medication is working as anticipated is another correct statement that demonstrates knowledge of the disease management. Blood glucose monitoring is an essential part of diabetes care, as it helps the patients and the health care providers to evaluate the effectiveness of the insulin therapy, the diet, and the exercise plan. Blood glucose monitoring also helps to prevent or detect hypoglycemia (low blood sugar) and hyperglycemia (high blood sugar), and to adjust the insulin dose accordingly.

Choice D reason: The things that I eat may impact the dose of my medication used to control my blood glucose is also a correct statement that reflects awareness of the disease implications. The amount and type of carbohydrates that the patients eat can affect their blood glucose level, as carbohydrates are the main source of glucose in the diet. Patients with type 1 DM need to balance their insulin dose with their carbohydrate intake, and follow a consistent and healthy eating pattern. They may also use carbohydrate counting, a method of estimating the grams of carbohydrates in the foods they eat, to help them plan their meals and snacks.

A. A 12-month-old who is 2-days post-op cleft palate repair whose vital signs are within normal limits B. A 6-month-old who is crying and becomes calm when held by a parent C. An 8-month-old with legs drawn to chest and a temperature of 39.5 degrees C D. A 4-month-old that has just returned from the recovery room

Correct Answer is C

Explanation

Choice A reason: This statement is false. A 12-month-old who is 2-days post-op cleft palate repair whose vital signs are within normal limits is not the priority for pain medication. This infant may have some pain from the surgery, but it is likely to be mild and manageable with non-pharmacological interventions, such as distraction, comfort, or oral care.

Choice B reason: This statement is false. A 6-month-old who is crying and becomes calm when held by a parent is not the priority for pain medication. This infant may have some pain from an unknown cause, but it is likely to be transient and responsive to non-pharmacological interventions, such as soothing, rocking, or cuddling.

Choice C reason: This statement is true. An 8-month-old with legs drawn to chest and a temperature of 39.5 degrees C is the priority for pain medication. This infant may have severe pain from an infection, such as appendicitis, meningitis, or urinary tract infection. This infant may also have signs of inflammation, such as fever, leukocytosis, or elevated C-reactive protein. This infant needs immediate pain relief and antibiotic therapy.

Choice D reason: This statement is false. A 4-month-old that has just returned from the recovery room is not the priority for pain medication. This infant may have some pain from the surgery, but it is likely to be moderate and controlled with pharmacological interventions, such as opioids, NSAIDs, or local anesthetics.

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When Jo returns home, the nurse provides education about long-term complications. The nurse explains the importance of annual/yearly screenings, such as eye exams and...

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which patient statement indicates to the nurse the need for further teaching regarding the new diagnosis of type 1 diabetes mellitus (DM)?

Correct Answer is A

Explanation

The nurse prioritizes which infant to administer pain medication to first? All have PRN (as needed) orders for pain medication.

Correct Answer is C

Explanation

A patient with multiple draining wounds is admitted for hypovolemia. Which assessment would be the most accurate way for the nurse to evaluate fluid balance?

Jo is a client with Type 1 Diabetes. Jo has a blood glucose level of 644 mg/dL. The nurse interprets that this client is most at risk of developing which type of acid-base imbalance?

A client has a serum potassium level of 2.9 mEq/L. Which action prescribed by the health care provider should the nurse take first?

The nurse is caring for a client receiving morphine through a Patient Controlled Analgesia Pump (PCA Pump). The nurse knows that important considerations for this treatment include: SELECT ALL THAT APPLY

A nursing student sees the nurse dip a pacifier in a sugar-water solution for an infant before administering an intramuscular injection. The nursing student asks why the nurse provided this sugar-water pacifier. The nurse’s appropriate response is: This will:

For the client mentioned above (nausea/vomiting, Salmonella infection), the nurse anticipates an order for which of the following IV fluids?

A patient with type 2 diabetes is scheduled for a follow-up visit in the clinic several months from now. Which test will the nurse schedule to evaluate the effectiveness of treatment for the patient?

The nurse is caring for a patient who has diabetes and complains of chronic, burning leg pain even when taking oxycodone (OxyContin) twice daily. Which prescribed medication is the best choice for the nurse to administer as an adjuvant to decrease the patient's pain?