A client with diabetic ketoacidosis (DKA) is receiving regular insulin. Which action should the practical nurse (PN) implement to evaluate the effectiveness of the insulin dosage?

Smell the client's breath for resolution of a fruity odor.

Determine the client's orientation to time and space.

Measure the client's urinary output for an increased volume.

Check fingerstick blood glucose for a decrease in the level.

Answer and Explanation

The Correct Answer is D

Regular insulin is the medication of choice for treating DKA. Its main action is to lower blood glucose levels by promoting the uptake of glucose into cells and inhibiting the production of glucose by the liver. Therefore, checking the fingerstick blood glucose level is an important indicator of the effectiveness of the insulin treatment.
A decrease in the blood glucose level indicates that the insulin is working to lower the high blood sugar associated with DKA. This measurement helps the PN assess the response to treatment and adjust the insulin dosage if necessary.
The other actions mentioned are also important assessments in the care of a client with DKA, but they do not specifically evaluate the effectiveness of the insulin dosage:
A. Smelling the client's breath for resolution of a fruity odor is important as it indicates a decrease in ketone production, which is a marker of improving DKA. However, it does not directly evaluate the effectiveness of the insulin dosage.
B. Determining the client's orientation to time and space is part of assessing their neurological status, which is crucial in managing DKA. However, it does not specifically assess the effectiveness of the insulin dosage.
C. Measuring the client's urinary output for an increased volume is important to monitor hydration status and renal function, but it does not directly evaluate the effectiveness of the insulin dosage.

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Correct Answer is C

Explanation

When the practical nurse (PN) notices that one of the unlicensed assistive personnel (UAP) consistently records subnormal temperatures when using the thermometer, the first action the PN should take is to observe how the UAP obtains temperatures. This allows the PN to directly assess the UAP's technique and determine if any errors or inaccuracies are occurring during temperature measurement. By observing the process, the PN can identify any potential issues, such as incorrect placement of the thermometer or improper technique, and provide appropriate guidance and education.

A. Insert an indwelling catheter to empty the bladder and contract the fundus. B. Check fundal consistency and continue to monitor the lochial ﬂow amount. C. Return the client to bed and maintain bedrest until the lochial ﬂow slows. D. Massage the fundus and avoid direct pressure on the cesarean incision.

Correct Answer is D

Explanation

This is the best action to take for a client who experiences a sudden gush of vaginal blood and clots after a cesarean section. Massaging the fundus helps to stimulate uterine contractions and reduce bleeding. Avoiding direct pressure on the incision prevents pain and wound dehiscence.

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A client with diabetic ketoacidosis (DKA) is receiving regular insulin. Which action should the practical nurse (PN) implement to evaluate the effectiveness of the insulin dosage?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The practical nurse (PN) notices that one of the unlicensed assistive personnel (UAP) working in the long- term care facility consistently records subnormal temperatures when using the thermometer. Which action should the PN take first?

Correct Answer is C

Explanation

On the first day after a cesarean section, a client who is a primipara is being assisted to the bathroom for the first time. The client experiences a sudden gush of vaginal blood and notices that several blood clots are in the toilet. Which action should the practical nurse (PN) take?

Correct Answer is D

Explanation

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