A client with type 2 diabetes mellitus (DM) is being discharged after treatment for an acute bronchitis infection. The nurse is providing teaching for medications to be taken at home, which includes a new prescription for self-administered glargine insulin 20 units SUBQ at bedtime. The client asks if they now have type 1 diabetes mellitus. How should the nurse respond?

Offer support while explaining that acute illness can change the type of diabetes and its treatment.

Advise the client that the insulin will be discontinued when the glycosylated haemoglobin A1C levels reflect good control.

Remind the client that DM is a chronic progressive disease and lifelong insulin is usually needed.

Explain that the insulin injections will probably be discontinued once stress and illness are resolved.

Answer and Explanation

The Correct Answer is D

Choice A reason: While acute illness can affect diabetes management and treatment, it does not change the type of diabetes. This response might confuse the client more, as type 1 and type 2 diabetes are different conditions.

Choice B reason: Advising the client that insulin will be discontinued when glycosylated haemoglobin A1C levels reflect good control can be misleading. While good control might reduce the need for insulin, the primary reason for insulin use here is the stress and illness, not just A1C levels.

Choice C reason: Reminding the client that diabetes mellitus is a chronic progressive disease and lifelong insulin is usually needed is not accurate for type 2 diabetes. Many clients with type 2 diabetes can manage their condition without lifelong insulin therapy.

Choice D reason: Explaining that insulin injections will probably be discontinued once stress and illness are resolved is accurate and helps the client understand that the need for insulin is likely temporary due to the acute condition and stress on their body. This response provides clarity and reassurance without causing unnecessary concern.

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Correct Answer is C

Explanation

Choice A reason: Lung sounds are important to assess for signs of fluid in the lungs, such as crackles, which can occur with fluid volume overload. However, they do not directly measure fluid balance.

Choice B reason: Turgor assesses skin elasticity and hydration status, but it is not the most accurate indicator of overall fluid balance in the context of fluid volume overload.

Choice C reason: Weight is the most accurate and direct measure of fluid balance. Daily weight monitoring can track changes in fluid status, as weight fluctuations can reflect gains or losses in body fluid.

Choice D reason: Blood pressure is important to monitor, especially in clients with fluid volume issues, but it is not the most direct measure of fluid balance. Weight changes provide more precise information about fluid status.

A. "Failure to keep your lungs working may result in pneumonia after surgery which could, in turn, result in death." B. "Incentive spirometry is conducted routinely after surgery and will be demonstrated when you return from surgery." C. "You will use the incentive spirometer for the first postoperative day until deep breathing and coughing can be done comfortably." D. "Deep breathing exercises are encouraged to maintain lung capacity and to strengthen respiratory muscles, which will help prevent complications."

Correct Answer is D

Explanation

Choice A reason: While it is important to communicate the risks of not using the incentive spirometer, this statement is overly alarming and may cause unnecessary anxiety for the client. It is better to focus on positive outcomes and preventive measures.

Choice B reason: This statement informs the client that incentive spirometry is routine and will be demonstrated postoperatively, but it does not provide specific details about its benefits or importance.

Choice C reason: This statement explains the use of the incentive spirometer on the first postoperative day, but it does not address the overall goal of preventing complications through lung exercises.

Choice D reason: This statement effectively explains the purpose and benefits of deep breathing exercises, including using the incentive spirometer. It emphasizes the importance of maintaining lung capacity and strengthening respiratory muscles to prevent complications, providing a clear rationale for the intervention.

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Naxlex Comprehensive Predictor Exams

A client with fluid volume overload is admitted to the hospital for diuresis. Which assessment should the nurse perform to evaluate the client's fluid balance?

Correct Answer is C

Explanation

The nurse is teaching the client about incentive spirometry in the preoperative unit. Which statement regarding incentive spirometry should the nurse include with preoperative teaching?

Correct Answer is D

Explanation

The nurse is assessing a client who is newly diagnosed with hypothyroidism. Which assessment finding requires immediate intervention?

During a home visit, the nurse should evaluate the effectiveness of a client's treatment for chronic obstructive pulmonary disease (COPD) by assessing for which primary symptom?

Which technique should the nurse use when assessing for early signs of rheumatoid arthritis?

The nurse is obtaining a health history from a new client who has a history of kidney stones. Which statement by the client indicates an increased risk for renal calculi?

The nurse is caring for a client with emphysema who is mildly dyspneic after ambulation. Which instruction should the nurse provide to the client to improve gas exchange?

A client with ulcerative colitis is admitted to the medical unit during an acute exacerbation. The nurse should instruct the unlicensed assistive personnel (UAP) to report which finding related to the client's bowel movements?

The nurse is assessing a client who has left ventricular heart failure. Which assessment finding is this client most likely to exhibit?

A client who is postmenopausal, obese, and is a smoker, has developed an intolerance to fatty foods and believes she is at risk for developing gallbladder problems. Which instruction should the nurse provide to help reduce the client's risk for gallbladder disease?