A nurse is assessing a client who has diabetes mellitus prior to performing a blood glucose test.

Which of the following findings should indicate to the nurse that the client has hyperglycemia?

Thirst.

Confusion.

Shakiness.

Cool skin.

Answer and Explanation

The Correct Answer is A

Thirst is a common symptom of hyperglycemia, or high blood sugar, in clients with diabetes mellitus.
Choice B is wrong because confusion can be a symptom of both hyperglycemia and hypoglycemia (low blood sugar).
Choice C is wrong because shakiness is more commonly associated with hypoglycemia.
Choice D is wrong because cool skin is not a common symptom of hyperglycemia.

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Correct Answer is A

Explanation

After postoperative surgery, chances of infections are very high also discharges, color changes, etc.
So it is important to expose the client’s abdomen to look for changes in appearance.

Choice B is not the answer because determining areas of resonance across the abdomen using a systematic approach is not the first action that should be taken 1.
Choice C is not the answer because using the diaphragm of a stethoscope to listen for bowel sounds is not the first action that should be taken 1.
Choice D is not the answer because performing abdominal palpation by pressing gently with the finger pads is not the first action that should be taken 1.

A. Remove the stopcocks from IV tubing. B. Cleanse the stoppers with povidone-iodine before withdrawing the medication. C. Ensure the gloves in the surgical suite are powdered gloves. D. Schedule the client as the first surgical procedure of the day.

Correct Answer is D

Explanation

Schedule the client as the first surgical procedure of the day.
When scheduling a surgical procedure for a patient with a latex allergy, it is recommended to schedule them as the first case of the day.
Choice A is wrong because removing the stopcocks from IV tubing does not address the issue of latex allergy.
Choice B is wrong because cleansing the stoppers with povidone-iodine before withdrawing medication does not address the issue of latex allergy.
Choice C is wrong because powdered gloves can contain latex and should be avoided for patients with a latex allergy.

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A nurse is assessing a client who has diabetes mellitus prior to performing a blood glucose test. Which of the following findings should indicate to the nurse that the client has hyperglycemia?

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A nurse is assessing a client who has diabetes mellitus prior to performing a blood glucose test.

Which of the following findings should indicate to the nurse that the client has hyperglycemia?