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 A

Explanation

Choice A reason: Washing hands with warm soapy water before sticking the finger is a critical step in the process of self-monitoring blood glucose. Clean hands help prevent infections and ensure that the blood sample is not contaminated, which can affect the accuracy of glucose readings. This practice indicates that the client understands and can effectively follow the proper procedure for SMBG.

Choice B reason: Using a lancing device on the centre of the finger pad is not the correct technique. The sides of the finger pads are recommended for pricking because they are less sensitive than the centre and can provide a better sample with less discomfort. This indicates a misunderstanding of the correct procedure.

Choice C reason: Informing the healthcare provider of average haemoglobin A1C results weekly is unnecessary. Haemoglobin A1C is typically measured every 3 to 6 months to monitor long-term glucose control. Weekly reporting is not required and shows a lack of understanding about the appropriate use of A1C measurements.

Choice D reason: Documenting haemoglobin A1C results from the SMBG monitor every morning is incorrect. The SMBG monitor measures daily blood glucose levels, not haemoglobin A1C. Haemoglobin A1C provides an average blood glucose level over the past 2 to 3 months and is not obtained from daily SMBG readings.

A. Call the postanesthetic care unit (PACU) nurse to prepare for prolonged ventilatory support. B. Determine if prescribed antibiotics were administered preoperatively. C. Hold a prescription for dantrolene until fever is reduced. D. Prepare ice packs for placement in the client's axillary area.

Correct Answer is D

Explanation

Choice A reason: Calling the postanesthetic care unit (PACU) nurse to prepare for prolonged ventilatory support is important in certain situations. However, in this case, the client's immediate concern is the extremely high temperature, which needs to be addressed urgently.

Choice B reason: Determining if prescribed antibiotics were administered preoperatively is a standard procedure, but it is not relevant to the acute situation of muscle rigidity and extremely high temperature caused by succinylcholine. The nurse should focus on immediate cooling measures.

Choice C reason: Holding a prescription for dantrolene until the fever is reduced is not appropriate. Dantrolene is actually used to treat malignant hyperthermia, which is characterized by muscle rigidity and a high temperature. It should be administered immediately in such cases.

Choice D reason: Preparing ice packs for placement in the client's axillary area is a direct and immediate action to help reduce the client's extremely high temperature. Cooling measures are crucial to manage hyperthermia and prevent further complications.

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Naxlex Comprehensive Predictor Exams

A client is newly diagnosed with type 2 diabetes mellitus. The nurse is educating the client about self-monitoring blood glucose (SMBG) and haemoglobin A1C. Which statement by the client indicates teaching has been effective?

Correct Answer is A

Explanation

A client in the operating room received succinylcholine. The client is experiencing muscle rigidity and has an extremely high temperature. Which action should the nurse implement?

Correct Answer is D

Explanation

A male client comes to the clinic with concerns of erectile dysfunction (ED). Which information is most important for the nurse to obtain?

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?

A 26-year-old client is admitted to the hospital for treatment of a simple goitre, and levothyroxine sodium is prescribed. Which symptoms indicate to the nurse that the prescribed dosage is too high for this client?

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

A client with a history of asthma reports having episodes of bronchoconstriction and increased mucus production while exercising. Which action should the nurse implement?

While assisting a client to the toilet, the client begins to have a seizure and the nurse eases the client to the floor. The nurse calls for help and monitors the client until the seizing stops. Which intervention should the nurse implement first?

The nurse is assessing a client who was admitted yesterday with peripheral artery disease (PAD) and an ulcer on the lateral malleolus. Which finding is most important for the nurse to report to the healthcare provider?