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.

Nursing Test Bank

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Naxlex Comprehensive Predictor Exams

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Free Nursing Study Resources

Correct Answer is C

Explanation

A. The need to match the daily steroid dose to immediate symptoms:
Explanation: Adjusting the steroid dose based on immediate symptoms is not a recommended approach. Patients should follow the prescribed regimen provided by their healthcare provider.

B. The importance of monitoring liver function:
Explanation: While monitoring liver function is important for some medications, it is not the primary focus when teaching about hormone replacement therapy in Addison's disease. The emphasis is on the need for life-long steroid replacement.

C. The need for life-long steroid replacement:
Explanation: Patients with Addison's disease require life-long steroid replacement therapy to compensate for the deficiency in adrenal hormones. It's important for the patient to understand that adherence to the prescribed steroid regimen is essential for maintaining health and preventing adrenal crisis.

D. The possibility extreme weight loss from the use of corticosteroids:
Explanation: While corticosteroids can have various side effects, extreme weight loss is not a typical or desired outcome of steroid therapy for Addison's disease. Weight changes and potential side effects should be discussed, but the emphasis should be on the importance of long-term steroid replacement.

A. Frequent mood changes B. Weight gain of 11 lbs in 3 weeks C. Sensitivity to cold D. Constipation

Correct Answer is A

Explanation

A. Frequent mood changes:
This is correct. Hyperthyroidism is associated with increased levels of thyroid hormones, which can affect the nervous system and lead to mood changes, including irritability and anxiety.

B. Weight gain of 11 lbs in 3 weeks:
Weight loss is more characteristic of hyperthyroidism due to increased metabolism. Rapid weight gain is not typical.

C. Sensitivity to cold:
Sensitivity to cold is more characteristic of hypothyroidism, where there is a deficiency of thyroid hormones.

D. Constipation:
Constipation is more commonly associated with hypothyroidism, where there is a slowing of the digestive system.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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?

Correct Answer is C

Explanation

A nurse is caring for a client who has hyperthyroidism. Which of the following manifestations should the nurse expect the client to report?

Correct Answer is A

Explanation

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

A nurse is performing a physical examination on an adolescent male suspected of having an endocrine disorder. Which of the following assessment findings might be indicative of a problem with the thyroid gland?

A patient with a longstanding diagnosis of generalized anxiety disorder presents to the emergency room. The triage nurse notes upon an assessment that the patient is hyperventilating. The triage nurse is aware that hyperventilation is the MOST common cause of which acid-base imbalance?

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)

The nurse is monitoring a client who was diagnosed with Type 1 Diabetes Mellitus and is being treated with NPH and regular insulin. Which manifestations alert the nurse to the presence of a possible hypoglycemic reaction? (SELECT ALL THAT APPLY)

A nurse is conducting a class on how to self-manage insulin regimens. A client asks how long a vial of insulin can be stored at room temperature before it "goes bad." What would be the nurse's best answer?

A patient has the following blood gases: PaCO2 33, pH 7.50, HCO3 23. Which of the following could NOT be the cause of this condition?