fundamentals passpoint week 2
The nurse reinforces disease management instructions for a client newly diagnosed with type 1 diabetes. Which statement indicates to the nurse that the client has understood the information?
"Checking my blood sugar before meals and at bedtime will help me manage my blood sugar."
An older child has received diet instruction as part of the treatment plan for type 1 diabetes. Which statement by the older child indicates to the nurse the need for additional instruction?
"I can eat whatever I want as long as I cover the calories with sufficient insulin." The goal of diet therapy in diabetes is to attain and maintain ideal body weight. Each child with diabetes will be prescribed a specific caloric intake and insulin regimen to help accomplish this goal.
The nurse is developing a teaching plan for a client diagnosed with diabetes insipidus. The nurse should include information about which hormone lacking in clients with diabetes insipidus?
Antidiuretic hormone (ADH)
Observation of a client reveals thin extremities, but an obese truncal area and a "buffalo hump" at the shoulder area with reports of weakness and disturbed sleep. The nurse interprets this data as indicating which disorder?
Clients with Cushing syndrome have truncal obesity with thin extremities and a fatty "buffalo hump" at the back of the neck. Clients with Addison's disease show signs of weakness, anorexia, and dark pigmentation of the skin. Clients with Graves' disease (hyperthyroidism) have symptoms of heat intolerance, irritability, and bulging eyes. Hyperparathyroidism is characterized by osteopenia and renal calculi.
A nurse observes a second nurse documenting a peripheral blood glucose level that the second nurse did not actually collect from a client with diabetes. What is the priority action by the nurse observing this situation?
Discuss the observation with the other nurse. The first action the nurse should take is to discuss what was witnessed with the other nurse and express concern that this behavior is unethical, unprofessional, and illegal. The nurse manager should be notified in order to follow up with the nurse. Documenting assessments that were not actually done on a legal document is illegal and constitutes professional misconduct. The other options do not reflect safe and competent care, nor do they protect the client.
A client is being returned to his room after a subtotal thyroidectomy. Which piece of equipment is most important for the nurse to keep at the client's bedside?
Tracheostomy set After a subtotal thyroidectomy, swelling of the surgical site (the tracheal area) may obstruct the airway. Therefore, the nurse should keep a tracheostomy set at the client's bedside in case of a respiratory emergency. Although an indwelling urinary catheter and a cardiac monitor may be used for a client after a thyroidectomy, the tracheostomy set is more important. A humidifier isn't indicated for this client.
The client is being evaluated for hypothyroidism. The nurse should stay alert for:
decreased body temperature and cold intolerance.
A client becomes upset when the health care provider diagnoses the client with diabetes mellitus because of the client's signs and symptoms. The client tells the nurse, "This must be a mistake. No one in my family has ever had diabetes." Based on this statement, the nurse suspects the client is using which coping mechanism?
denial Initially, many clients use denial to cope with unpleasant or shocking news, such as the diagnosis of diabetes mellitus. Although withdrawal, anger, and resolution are also coping mechanisms, they surface later in the readjustment period after the client realizes the information is correct.
A client with a history of diabetes has serum ketones and a serum glucose level above 300 mg/dL. Which condition does the nurse expect is the cause?
diabetic ketoacidosis Clients with serum ketones and serum glucose levels above 300 mg/dL could be diagnosed with diabetic ketoacidosis. Diabetes insipidus is an overproduction of antidiuretic hormone and doesn't create ketones in the blood. Hypoglycemia causes low blood glucose levels. The Somogyi phenomenon is rebound hyperglycemia following an episode of hypoglycemia.
The nurse is caring for a client with suspected parathyroid dysfunction. Which laboratory results support a diagnosis of primary hyperparathyroidism?
high parathyroid hormone and high calcium levels A diagnosis of primary hyperparathyroidism is established based on increased serum calcium levels and elevated parathyroid hormone levels. Potassium, magnesium, TSH, and thyroid hormone levels aren't used to diagnose hyperparathyroidism.
