NCLEX-RN Metabolism

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An adult with type 2 diabetes mellitus has been NPO since 2200 in preparation for having a nephrectomy the next day. At 0600 on the day of surgery, the nurse reviews the client's medical record and laboratory results. Which finding should the nurse report to the health care provider (HCP)?

Correct response: blood glucose of 140 mg/dL (7.8 mmol/L)

A client is diagnosed with a goiter after traveling in a foreign country for 3 months. During the trip, the client could not tolerate food. Which signs and symptoms would the nurse expect to see in this client? Select all that apply.

Correct response: dizziness when raising the arms above the head dysphagia respiratory distress

A client has had an hypophysectomy. What signs of a potential complication should the nurse teach the client to report?

Correct response: hypopituitarism

Laboratory studies indicate a client's blood glucose level is 185 mg/dl (10.2 mmol/L). Two hours have passed since the client ate breakfast. Which test would yield the most conclusive diagnostic information about the client's glucose use?

Correct response: serum glycosylated hemoglobin (Hb A1c)

A client with hypothyroidism (myxedema) is receiving levothyroxine, 25 mcg P.O. daily. Which finding should the nurse recognize as an adverse reaction to the drug?

Correct response: tachycardia

A nurse is assessing a client after a thyroidectomy. The assessment reveals muscle twitching and tingling, along with numbness in the fingers, toes, and mouth area. The nurse should suspect which complication?

Correct response: tetany

The nurse is instructing the client with hypothyroidism who takes levothyroxine 100 mcg, digoxin, and simvastatin. The nurse judges that the teaching regarding the use of these medications is effective if the client will take:

Correct response: the levothyroxine before breakfast and the other medications 4 hours later.

The nurse should assess a client taking chlorpropamide for:

Correct response: hypoglycemia.

The nurse is caring for a 27-year-old female client who presents today with worsening fatigue.

Select the anticipated interventions from each of the following categories. Heading Answer Choices Medical Management ferrous sulfate 325 mg orally once per day with orange juiceNutrition Management ---- Client EducationIncrease vitamin C intake.

The nurse in the wound clinic is caring for a 74-year-old male client with a foot ulcer secondary to type 2 diabetes. The nurse is reviewing with the health care provider the wound assessment from 4 days earlier and today. Which diagnostic test(s) should the nurse anticipate will be prescribed? Select all that apply.

white blood cell count erythrocyte sedimentation rate C-reactive protein bone scan wound culture

Which statement indicates that the client with diabetes insipidus understands how to manage care? The client will:

Correct response: maintain normal fluid and electrolyte balance.

The adrenal cortex is responsible for producing which substances?

Correct response: glucocorticoids and androgens

A client is diagnosed with pancreatitis. Which assessment would be of most concern to the nurse?

Correct response: bluish discoloration in periumbilical area

A hospitalized client who is 26 weeks' pregnant has been diagnosed with gestational diabetes. She is overweight and doesn't understand the diet that the healthcare provider has prescribed. To help the client understand the diet, the nurse would teach the client to choose what food types for a typical meal?

Correct response: brown rice, spinach, pork tenderloin

A client in cardiac rehabilitation would like to eat the right foods to ensure adequate endurance on the treadmill. Which nutrient is most helpful for promoting endurance during sustained activity?

Correct response: carbohydrate

The client with acute renal failure asks the nurse for a snack. Because the client's potassium level is elevated, which snack is most appropriate?

Correct response: a gelatin dessert

A client visits the mental health clinic and tells the nurse that she is lethargic, experiences pain in her back, cannot concentrate, and is depressed. The nurse observes patches of hair loss on the client's scalp. Which referral should the nurse make first?

Correct response: a health care provider

A client with diabetes mellitus has had declining renal function over the past several years. Which diet regimen should the nurse recommend to the client on days between dialysis?

Correct response: a low-protein diet with a prescribed amount of water

A client is diagnosed with cystic fibrosis. Which intervention would be performed to prevent nutrition complications?

Correct response: administration of pancreatic enzymes

A new mother is concerned because her breast-feeding neonate wants to "nurse all the time." Which response best indicates the normal neonate's breast-feeding behavior?

Correct response: "Breast milk is ideal for your baby, so his stomach will digest it quickly, requiring more feedings."

The nurse is teaching dietary considerations to a client who had a gastric resection. The nurse understands that the instruction has been effective if the client says which statement?

Correct response: "I will rest for 30 minutes after eating."

A 24-year-old client with diabetes mellitus sustains a large laceration that requires suturing. Which statement indicates that the client understands wound healing?

Correct response: "It's so hard to predict when this scar will disappear."

The nurse is caring for a 12-hour-old neonate born to a mother with diabetes mellitus. The neonate's respiratory rate is 70 breaths/minute, heart rate 162 beats/minute, oxygen saturation is 92% on room air, and the blood glucose 30 mg/dL (1.7 mmol/L). What is the priority intervention for the nurse to implement?

Correct response: Administer glucose.

A client presents to the clinic for a follow-up visit for hospitalization due to uncontrolled diabetes. Which of the following assessment findings indicates a complication of diabetes mellitus?

Correct response: Blood pressure of 160/100 mm Hg

To reduce the incidence of complications in a client in traction, which intervention should be included in the care plan?

Correct response: Increase fiber intake.

An adolescent is brought to the emergency department in a coma and is diagnosed with diabetic ketoacidosis. What is the correct action for the nurse to take?

Correct response: Infuse intravenous fluids as prescribed.

The nurse is caring for a 2-hour old, full-term, breastfeeding newborn. The nurse notes the following assessments: apical pulse, 122 bpm; axilla temperature, 96.6° F (35.9° C); jitteriness. Based on this assessment, what should the nurse should do first?

Correct response: Obtain a blood glucose sample.

The nurse is assessing children at risk for phenylketonuria (PKU). Which child is at greatest risk?

Correct response: blond, blue-eyed, fair-skinned child with eczema


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