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: Effectively managing pain, discomfort, and diarrhea is important for the client’s quality of life, but it does not address the long-term goal of preventing disease progression and complications.

Choice B reason: Ensuring careful fluid and electrolyte balance is critical, especially during acute exacerbations, but it is more of an immediate concern rather than a long-term goal.

Choice C reason: Reducing the number and severity of acute exacerbations is the most important long-term goal for clients with chronic ulcerative colitis. This goal focuses on maintaining remission, preventing complications, and improving overall prognosis by minimizing flare-ups.

Choice D reason: Maintaining a diet that is high in fibber content can be beneficial for overall health but may not always be suitable for clients with ulcerative colitis, especially during flare-ups. It is not the most critical long-term goal for managing the condition.

A. Pain in lower legs when walking. B. Black eschar over ankle ulcer. C. Absent pedal pulses by Doppler. D. Dependent rubor of lower extremities.

Correct Answer is C

Explanation

Choice A reason: Pain in the lower legs when walking, also known as intermittent claudication, is a common symptom of PAD but does not indicate an immediate threat to limb viability.

Choice B reason: Black eschar over the ankle ulcer indicates necrotic tissue, which is concerning but not as immediately critical as absent pulses. It does need to be monitored and treated to prevent infection and further complications.

Choice C reason: Absent pedal pulses by Doppler indicate a significant reduction in blood flow to the lower extremities, which can lead to critical limb ischemia and requires immediate intervention to restore perfusion and prevent tissue loss.

Choice D reason: Dependent rubor (redness when the leg is in a dependent position) is a sign of poor arterial circulation but does not require as urgent intervention as absent pedal pulses.

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Naxlex Comprehensive Predictor Exams

In planning care for a client with chronic ulcerative colitis, which long-term goal is most important for the nurse to include?

Correct Answer is C

Explanation

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?

Correct Answer is C

Explanation

A client who is receiving normal saline IV at 75 mL/hour has dry, sticky mucous membranes, and inelastic skin turgor. Which action should the nurse implement?

A female college student comes to the school's health clinic reporting urinary frequency and burning with right lower back pain. Which intervention should the nurse implement first?

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?

A client with cholelithiasis is admitted with jaundice due to obstruction of the common bile duct. Which finding is most important for the nurse to report to the healthcare provider?

The nurse calculates the body mass index (BMI) for an adult client who is obese. Which additional assessment finding places the client at high risk for cardiac disease?

The nurse is performing a physical assessment of a client. Which finding should the nurse recognize is a result of a compromised peripheral arterial circulation of the lower extremity?

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?

The nurse is preparing a prescription for enoxaparin 40 mg subcutaneous (sub) daily. Enoxaparin is available in a pre-filled cartridge labelled, "60 mg per 0.6 mall" How many mL should the nurse administer? (Enter numeric value only. If rounding is required, round to the nearest tenth.)