A client with a history of type 1 diabetes mellitus (DM) and asthma is readmitted to the unit for the third time in two months with a current fasting blood sugar (FBS) is 325 mg/dL (18 mmol/L). The client describes to the nurse of not understanding why the blood glucose level continues to be out of control. Which intervention(s) should the nurse implement? (Select all that apply.)

Have the client demonstrate technique used to monitor blood glucose levels.

Evaluate the client's asthma medications that can elevate the blood glucose.

Ask the client if they want a different manufacturer's glucose monitoring device.

Understand the client's daily routine

Ensuring the client uses a new insulin needle for each administration

Answer and Explanation

Correct Answer : A,B,D,E

A) Correct - Demonstrating the technique used to monitor blood glucose levels is crucial.

Incorrect technique can lead to inaccurate readings, impacting insulin dosing decisions and blood sugar control.
B) Correct - Some asthma medications, like corticosteroids, can elevate blood glucose levels.

Evaluating the client's asthma medications is essential as they can contribute to fluctuations in blood sugar levels.
C)   Incorrect- Asking the client if they want a different manufacturer's glucose monitoring device is not helpful, because it does not address the underlying causes of the poor glycemic control. The client may also perceive this as a lack of confidence in their ability to manage their diabetes or as a criticism of their choice of device. The nurse should focus on educating the client on how to use their current device correctly and consistently, rather than suggesting a change that may not be necessary or feasible.
D)   Correct - Understanding the client's daily routine helps identify factors influencing blood glucose control, such as meal timing, activity level, and stress. This information aids in creating a personalized diabetes management plan.
E)   Correct - Ensuring the client uses a new insulin needle for each administration is important for preventing infection and complications. Reusing needles can affect injection site health and insulin absorption.

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Correct Answer is B

Explanation

A) Incorrect- Liver enzymes are important for assessing liver function, but they are not the primary concern when a client with chronic kidney disease is feeling increasingly tired. Epoetin alfa injections are used to stimulate red blood cell production, so the nurse should review a laboratory value related to anemia.
B) Correct- Epoetin alfa is a medication that stimulates the production of red blood cells and is often used to treat anemia associated with chronic kidney disease. A complete blood count (CBC) would provide information about red blood cell levels, hemoglobin, and hematocrit, which are essential for assessing the effectiveness of the treatment.
C) Incorrect- Serum electrolytes are important for assessing overall kidney function and electrolyte balance, but the primary concern here is the client's increasing fatigue. Reviewing a value related to anemia and red blood cell production would be more appropriate.
D) Incorrect- Platelet count is important for assessing blood clotting function, but it's not directly related to the client's increasing fatigue. Anemia-related laboratory values should be the focus.

A. “Come into the recreation area. We have your favorite card game and I will play it with you." B. "Why do you want to stay in your room today?” C. "I know you are sad about not seeing your family as often, but they are visiting as much as they can.” D. d “May I sit with you for a while?"

Correct Answer is D

Explanation

d. “May I sit with you for a while?"

This comment shows empathy, respect, and support for the client, without being intrusive or judgmental. The PN acknowledges the client's feelings and oﬀers companionship, which can help reduce isolation and loneliness.

The other options are not correct because:

This comment may be perceived as coercive or dismissive of the client's feelings, as it tries to persuade the client to do something he does not want to do or enjoy.
This comment may be perceived as accusatory or interrogatory, as it questions the client's decision or motive for staying in his room.
This comment may be perceived as minimizing or invalidating the client's feelings, as it implies that the client should not be sad or that his family is doing enough for him.

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Naxlex Comprehensive Predictor Exams

A client with chronic kidney disease reports to the nurse of feeling increasingly tired. The client receives injections for epoetin alfa three times a week. Which laboratory value should the nurse review?

Correct Answer is B

Explanation

A chronically depressed older male resident of a long-term care facility has become more reclusive and today refuses to leave his room. His family has moved away and are unable to visit as much as in the past. Which comment by the practical nurse (PN) is likely to be most helpful to this client?

Correct Answer is D

Explanation

A client who had orthopedic surgery three days ago verbalizes difficulty in sleeping. Which initial intervention is best for the practical nurse (PN) to implement?

What action should the nurse take first when a client is inadvertently given an incorrect dose of a medication?

The practical nurse (PN) plans to screen only high risk children for scoliosis. Which group of children should the PN screen?

The practical nurse (PN) observes a newly hired unlicensed assistive personnel (UAP) who is counting a client's radial pulse as seen in the picture. Which action should the PN take?

Which actions should the practical nurse (PN) include when assessing a client for signs and symptoms of ﬂuid volume excess? (Select all that apply.)

While caring for a client with Guillain-Barre syndrome, which finding should the practical nurse (PN) report to the charge nurse?

The practical nurse (PN) and unlicensed assistive personnel (UAP) enter a client's room and find the client lying on the bed. The PN determines that the client is unresponsive. Which instruction should the PN give the UAP first?