A nurse is discussing the care of a client who has type 1 diabetes mellitus with an assistive personnel (AP). Which of the following situations should the nurse instruct the AP to report immediately?
The client refuses breakfast and requests to sleep.
The client asks the AP to trim his broken toenail.
The client reports urine that is dark yellow in color.
The client reports dizziness when standing.
The Correct Answer is A
Choice A rationale:
Type 1 diabetes mellitus is a chronic medical condition that occurs when the pancreas, an organ in the abdomen, produces very little or no insulin. Insulin is a hormone that helps the body to use glucose for energy. Glucose is a sugar that comes, in large part, from foods we eat. Insulin allows glucose to enter cells in the body. Therefore, if a client with type 1 diabetes refuses breakfast and requests to sleep, it could lead to hypoglycemia, a condition characterized by abnormally low blood glucose levels. Hypoglycemia can cause symptoms such as weakness, sweating, confusion, and in severe cases, unconsciousness or seizures. It is a medical emergency and should be reported immediately.
Choice B rationale:
Trimming a toenail may seem like a simple task, but for a person with diabetes, it can lead to serious complications. Diabetes can cause nerve damage that leads to numbness in the feet, making it difficult for a person to feel a cut, blister, or sore. These injuries can become infected and lead to serious complications, such as the need for amputation. However, this situation is not as immediately life-threatening as hypoglycemia and does not need to be reported immediately.
Choice C rationale:
Dark yellow urine can be a sign of dehydration, which can be a concern for individuals with diabetes. However, it can also be a result of less serious causes such as certain medications, foods, or simply not drinking enough fluids. While it’s important for the AP to encourage the client to drink more fluids, this situation is not as immediately life-threatening as hypoglycemia.
Choice D rationale:
Dizziness when standing, also known as orthostatic hypotension, can be a side effect of some medications used to treat diabetes. It can also be a symptom of dehydration or other conditions. While it’s important for the AP to monitor the client’s symptoms and report any changes, this situation is not as immediately life-threatening as hypoglycemia
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale:
Rifampin Rifampin is an antitubercular drug that is effective against all strains of Mycobacterium tuberculosis. It works by inhibiting the synthesis of RNA in the bacteria, preventing them from reproducing. However, it does not typically cause a decrease in visual acuity.
Choice B rationale:
Ethambutol Ethambutol is an antitubercular drug that can cause ocular toxicity in the form of visual field changes. It is known to induce toxic optic neuropathy, which is quite common and can lead to a decrease in visual acuity. Patients on Ethambutol therapy are advised to report any changes in visual acuity or eye discomfort immediately to their healthcare provider.
Choice C rationale:
Streptomycin Streptomycin is an aminoglycoside antibiotic used in the treatment of tuberculosis. It works by inhibiting protein synthesis in bacteria. While it can cause side effects such as ototoxicity and nephrotoxicity, it is not typically associated with a decrease in visual acuity.
Choice D rationale:
Isoniazid Isoniazid is a first-line antitubercular drug that works by inhibiting the synthesis of mycolic acids in the cell wall of Mycobacterium tuberculosis. While it can cause peripheral neuropathy, it is not typically associated with a decrease in visual acuity.
Correct Answer is C
Explanation
Choice A rationale:
Erythromycin Erythromycin is a macrolide antibiotic that is often used as an alternative to penicillin. It is generally safe for use in patients with a penicillin allergy. It works by inhibiting bacterial protein synthesis and is effective against a wide range of bacteria.
Choice B rationale:
Amphotericin B Amphotericin B is an antifungal medication, not an antibiotic. It is used to treat serious, systemic fungal infections. It has no cross-reactivity with penicillin, so it would not be a concern for a patient with a penicillin allergy.
Choice C rationale:
Amoxicillin-clavulanate Amoxicillin-clavulanate is a type of penicillin antibiotic. Patients with a known penicillin allergy should avoid this medication, as they may have a cross-reactivity to it. This is why the nurse should verify this prescription with the provider.
Choice D rationale:
Gentamicin Gentamicin is an aminoglycoside antibiotic used to treat serious bacterial infections caused by gram-negative bacteria. It is not related to penicillin and would be safe for a patient with a penicillin allergy.
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