A nurse is caring for a client who has type 1 diabetes mellitus. The client reports that she is not feeling well. Which of the following findings should indicate to the nurse that the client is hypoglycemic? (Select all that apply.)

Acetone breath odor

Polydipsia

Inability to concentrate

Diaphoresis

Tremors

Answer and Explanation

Correct Answer : C,D,E

Rationale:
A. Acetone breath odor: A fruity or acetone breath odor occurs when the body produces ketones due to fat breakdown in hyperglycemia or diabetic ketoacidosis (DKA). This finding is not associated with hypoglycemia but rather prolonged high blood glucose levels.

B. Polydipsia: Excessive thirst (polydipsia) is a sign of hyperglycemia because the kidneys attempt to excrete excess glucose, leading to dehydration. It does not occur during hypoglycemia, when blood sugar levels are abnormally low.

C. Inability to concentrate: Low blood glucose deprives the brain of its primary energy source, leading to confusion, irritability, and difficulty concentrating. These neuroglycopenic symptoms are hallmark signs of hypoglycemia and can progress to altered consciousness if untreated.

D. Diaphoresis: Sweating is a classic adrenergic response to hypoglycemia as the body releases epinephrine to raise blood glucose levels. It serves as an early warning sign, prompting immediate carbohydrate intake to prevent further decline in blood sugar.

E. Tremors: Tremors occur due to increased sympathetic nervous system activity during hypoglycemia. The body responds to falling glucose by releasing catecholamines, which stimulate muscle activity and cause shaking or trembling sensations.

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Free Nursing Study Resources

Correct Answer is A

Explanation

Rationale:
A. Advise the client to wait 1 hr before showering or swimming: Testosterone gel should be allowed to fully absorb into the skin before washing or swimming, typically waiting at least 1 hour. This ensures optimal absorption and therapeutic effect.

B. Instruct the client to have his testosterone checked in 1 week: Testosterone levels are generally evaluated after several weeks of therapy to assess effectiveness, not after just one week.

C. Wear clean gloves to apply the gel: The client should apply the medication themselves using clean, dry hands. The nurse should wear gloves only if assisting to prevent unintentional hormone absorption.

D. Apply the gel to the client's genital region: Testosterone gel should not be applied to the genitals due to increased absorption risk and skin irritation. Recommended sites include shoulders, upper arms, or abdomen.

A. Discharge the client to hospice care. B. Place a sign with "Do Not Resuscitate" outside the client's room. C. Explain to the client they can change their mind at any time. D. Obtain consent from the family for the change to the plan of care.

Correct Answer is C

Explanation

Rationale:
A. Discharge the client to hospice care: While hospice care may be appropriate for clients with end-stage disease, discharge to hospice is not the immediate nursing action in response to a DNR request. The priority is to acknowledge the client’s wishes and ensure the DNR order is properly documented.

B. Place a sign with "Do Not Resuscitate" outside the client's room: A visible sign is used after a formal DNR order is entered into the medical record. Placing a sign prematurely without provider authorization or documentation does not legally protect the client’s wishes.

C. Explain to the client they can change their mind at any time: It is important to respect client autonomy while clarifying that a DNR order is revocable. Providing this information supports informed decision-making and ensures the client understands that their preferences can be updated at any time.

D. Obtain consent from the family for the change to the plan of care: The client’s decision regarding resuscitation takes priority if they have decision-making capacity. Family consent is not required for a competent adult to make a DNR decision.

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A nurse is caring for a client who has type 1 diabetes mellitus. The client reports that she is not feeling well. Which of the following findings should indicate to the nurse that the client is hypoglycemic? (Select all that apply.)

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