A client with type 2 diabetes normally achieves adequate glycemic control through diet and exercise. Upon being admitted to the hospital for a cholecystectomy, however, the client has required insulin injections on two occasions. The nurse would identify what likely cause for this short-term change in treatment?

Stress has likely caused an increase in the client's blood sugar levels.

The client's volatile fluid balance surrounding surgery has likely caused unstable blood sugars.

The client has likely overstimulated her ability to control her diabetes using non-pharmacologic measures.

Alterations in bile metabolism and release have likely caused hyperglycemia.

Answer and Explanation

The Correct Answer is A

A. Stress has likely caused an increase in the client's blood sugar levels:
This statement is accurate. Stress, especially related to surgery, can lead to increased levels of stress hormones, such as cortisol and catecholamines, which can elevate blood sugar levels. Surgery is a physiological stressor that can impact glucose metabolism.

B. The client's volatile fluid balance surrounding surgery has likely caused unstable blood sugars:
This is the most appropriate choice. Surgery, anesthesia, and changes in fluid balance can affect blood glucose levels. The stress response to surgery can lead to fluctuations in blood sugar, and patients may need insulin during this period.

C. The client has likely overstimulated her ability to control her diabetes using non-pharmacologic measures:
This statement is not accurate. Overstimulation is not a common cause of the need for insulin in the context of surgery. The stress and physiological changes associated with surgery are more likely contributors.

D. Alterations in bile metabolism and release have likely caused hyperglycemia:
While alterations in metabolism can impact glucose regulation, in the context of surgery, the primary factors are the stress response, changes in fluid balance, and potential alterations in the ability to eat or drink normally rather than specific effects on bile metabolism.

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Correct Answer is D

Explanation

A. Flushed skin: Flushed or warm skin is more characteristic of hyperthyroidism, where there is an excess of thyroid hormones.

B. Palpitations: Palpitations or a rapid heartbeat are more characteristic of hyperthyroidism, where there is an excess of thyroid hormones.

C. Bulging eyes: Bulging or protruding eyes, known as exophthalmos, is a characteristic sign of Graves' disease, which is a specific type of hyperthyroidism.

D. Fatigue: This is correct. Fatigue is a common symptom of hypothyroidism, reflecting the overall slowing down of the body's processes.

A. "When I went to the restroom the last few days, my urine smelled odd." B. "I've always been a fan of sweet foods, but lately I'm turned off by them." C. "No matter how much sleep I get, it seems to take me hours to wake up." D. "Lately, I drink a lot, but I can't seem to quench my thirst."

Correct Answer is D

Explanation

A. "When I went to the restroom the last few days, my urine smelled odd."
Changes in the smell of urine can be associated with various conditions, including diabetes. However, it's not a specific symptom.

B. "I've always been a fan of sweet foods, but lately I'm turned off by them."
A change in taste preferences may not be directly related to diabetes. It's not a typical symptom.

C. "No matter how much sleep I get, it seems to take me hours to wake up."
Fatigue and difficulty waking up are general symptoms that can be caused by various factors, including diabetes. However, it's not specific to diabetes alone.

D. "Lately, I drink a lot, but I can't seem to quench my thirst."
Excessive thirst (polydipsia) and increased urination (polyuria) are classic symptoms of diabetes, suggesting elevated blood sugar levels.

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Naxlex Comprehensive Predictor Exams

The nurse is caring for a patient diagnosed with hypothyroidism. When assessing this patient, what sign or symptom would the nurse expect?

Correct Answer is D

Explanation

An occupational health nurse is screen a group of workers for diabetes. What statement should the nurse interpret as being suggestive of diabetes?

Correct Answer is D

Explanation

A nurse is caring for a patient with Addison's Disease. Which of the following clinical manifestations should the nurse expect to observe? (SELECT ALL THAT APPLY)

The nurse is preparing to administer Insulin Lispro (Humalog) to a client with Type 1 Diabetes Mellitus for sliding scale coverage. The nurse understands the injection is given:

A client with Cushing's syndrome is receiving education about dietary changes from the nurse. Which statement by the patient demonstrates the need for further teaching?

The nurse reviews the blood gas results of a client with atelectasis. The nurse analyzes the results and determines that the client is experiencing respiratory acidosis. Which results validate the nurse's findings?

The nurse teaches a diabetic client about Sick Day Rules. Which patient statement or statements indicate understanding of the Sick Day Rules? (SELECT ALL THAT APPLY)

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The nurse is caring for a patient with Addison's disease who is scheduled for discharge. When teaching the patient about hormone replacement therapy, the nurse should address what topic?

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